(U)- Interstitial Cystitis Flashcards

1
Q

What is interstitial cystitis?

A

Chronic condition causing inflammation in the bladder causing LUTS

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2
Q

How does interstitial cystitis present?

A

Suprapubic pain
Worse with full bladder, relieved on emptying

Frequency

Urgency

Symptoms worsen during menstruation

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3
Q

What investigations are used for interstitial cystitis?

A

Urinalysis- UTI
Swabs- STI
Cystoscopy- bladder cancer
Prostate exam- prostatitis, hypertrophy or cancer

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4
Q

What are Hunner lesions?

A

Seen during cystoscopy 5-20% of the time in interstitial cystitis

Red inflamed patches of bladder mucosa associated with small blood vessels

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5
Q

What is found on cystoscopy in patients with interstitial cystitis?

A

Hunner lesions

Granulations (tiny haemorrhages on bladder wall)

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6
Q

How is interstitial cystitis managed?

A

Symptoms often resistant to treatment, significant impact on QoL

Supportive management
- Diet, avoid alcohol, caffeine and tomatoes
- Stop smoking
- Pelvic floor exercises
- Bladder retraining
- CBT
- Transcutaneous electrical nerve stimulation

Oral medications
- Analgesia
- Antihistamines
- Anticholinergics (solifenacin or oxybutynin)
- Mirabegron (B3 agonist)
- Cimetidine (H2 antagonist)
- Pentosan polysulphate sodium
- Ciclosporin (immunosuppressant)

Intravesical medication
- Lidocaine
- Pentosan polysulphate sodium
- Hyaluronic acid
- Chondroitin sulphate

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7
Q

What is hydrodistension?

A

Filling bladder with water to high pressure during cystoscopy

Requires general anaesthetic

3-6 month symptom improvement

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8
Q

What surgical procedures are used for interstitial cystitis?

A
  • Cauterisation of Hunner lesions
  • Botulinum toxin injections 300 units
  • Neuromodulation
  • Augmentation of bladder, using section of ileum to increase capacity
  • Cystectomy
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