Interstitial cystitis

Question 1

What is the presentation?

Answer 1

More than 6 weeks of:
- Suprapubic pain, worse with a full bladder
- Frequency of urination
- Urgency of urination
- Sx worse during menstruation

Question 2

What are the investigations and why

Answer 2

Urinalysis - for UTI
Swabs for STIs
Cystoscopy for bladder cancer
Prostate exam

Question 3

What can be found during cystoscopy

Answer 3

Hunner’s lesions - red inflamed patches in the bladder mucosa
Granulations - small haemorrhages on the bladder wall

Question 4

What does supportive management involve?

Answer 4

Diet changes - avoid alcohol, caffeine, tomatoes
Stop smoking
pelvic floor exercises
bladder retraining
CBT
TENS

Question 5

What oral meds can be helpful?

Answer 5

Analgesia
Antihistamines
Anticholinergics - solifenacin or oxybutynin
Mirebegron
Cimetidine
Pentosan polysulfate sodium
Ciclosporin

Question 6

What intravesical meds can be given

Answer 6

Lidocaine
Pentosan polysulphate sodium
hyaluronic acid
chondroitin sulphate

Question 7

What is hydrodistension?

Answer 7

Filling bladder with water to high pressure during cystoscopy to give temporary improvement in sx

Question 8

What are surgical options

Answer 8

cAUTERISATION of Hunners lesions
Botulinum toxin injections