This painful, chronic inflammation of the bladder varies considerably in its severity and symptoms, depending upon the form of the disease. Nonulcerative interstitial cystitis by far the most common type develops mostly in young to middle aged women, and is marked by intermittent episodes of abdominal and bladder pain, urinary urgency, and painful sexual intercourse. Bladder capacity remains constant or perhaps slightly increased, in marked contrast to the more severe ulcerative form, which occurs mostly in older women and accounts for only 5 to 10 percent of cases. In this latter type, the bladder holds less urine than normal, and cracks, scars, and star shaped sores called Hunner’s ulcers, which sometimes bleed when the bladder is full, develop in the muscular wall. In time, the bladder wall becomes thickened and stiff. The incidence of interstitial cystitis is unknown, but it’s been estimated that it afflicts 500,000 Americans, 90 percent of them women. Unlike ordinary cystitis , which is usually caused by a bacterial infection, interstitial cystitis has no known cause. Possible predisposing factors are under study, including frequent childhood urinary tract infections, bladder damage from surgery, and toxic substances in the urine. Stress appears to trigger flare ups.
Other Causes of Bladder Inflammation
A bacterial urinary tract infection is the most common cause of bladder inflammation. Symptoms may also be produced by bladder stones, urethritis, or an enlarged prostate.
Diagnostic Studies And Procedures
here is no single test to diagnose interstitial cystitis, but a doctor suspects it when a patient describes symptoms of cystitis but a urine culture fails to grow bacteria and antibiotics do not alleviate discomfort. Before concluding that a patient has interstitial cystitis, however, a doctor must rule out other conditions, including urinary tract or genital infections, cancer, kidney or bladder stones, and neurological disorders. The doctor may inspect the bladder by cystoscopy, in which a lighted viewing device is inserted into the urethra and bladder. In nonulcerative cystitis, the bladder may appear normal. (In the ulcerative form, cystoscopy usually reveals the characteristic scarring and ulcers) Even if the bladder appears normal, tiny areas of pin point bleeding called glomerulations are often revealed after the organ is distended by filling it with water or gas. Both cystoscopy and bladder distention are painful procedures that are performed after adminis tering local anesthesia.