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Interstitial Cystitis Can Mimic Other Common Female Pelvic Conditions

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Interstitial Cystitis (IC) is a chronic pain syndrome of the bladder that is often now included within Painful Bladder Syndrome (PBS). IC is noted for symptoms of pelvic pain, urgency, frequency, nocturia in the absence of bacterial infection.
Some surveys show that it may be present in up to 2% of all women. The chronic nature of the symptoms can be debilitating and have a profound negative impact on quality of life.

What causes IC is not well understood, but it may be secondary to defective bladder lining that then allows acid/other toxins to permeate into the bladder wall and lead to pain. Pain nerves are stimulated but perhaps maintain an “on” state where pain is perceived in the absence of the bad stimulus.

After a bladder infection is cleared with antibiotics, the pain and symptoms resolve. In IC the nerves that send pain signals may continue to be active despite the fact that no toxin/bacteria are present any longer.

So what common diagnoses can IC mimic? In other words, most or all of the following conditions are often diagnosed first, while IC becomes a diagnosis of exclusion once these common problems have been ruled out.

Recurrent UTIs- a simple culture can verify the presence of bacteria, but if UTIs are really reoccurring, a search for why bacteria persist or recurs must be sought after.

Endometriosis- this could lead to pelvic pain and bladder symptoms, as well as pain with sex. Pain with endometriosis will mimic the menstrual cycle and laparoscopy with a gynecologist can make the diagnosis.

Chronic Pelvic Pain- this is usually defined as pain for at least 6 months with unclear etiology. It can be from the back, buttocks, abdominal wall muscles, and the pain leads to functional impairment. Common causes are: adhesions, pelvic inflammatory disease, ovarian pain, radiation pain, and so on…)

Vulvodynia- this is pain emanating from the opening of the vagina in the absence of any clear pathology. The vulva and the bladder share nerve endings and are derived from similar structures in development and there is likely some crossover in perception of symptoms. Often IC and vulvodynia will be diagnosis together in about half of all IC cases.

Overactive Bladder (OAB)- This is a common constellation of symptoms of urgency, frequency, and urge incontinence, with or without nocturia. It does not involve chronic pain. Often, OAB can be managed with fluid/diet/caffeine control, and if more severe, medication.

Bladder cancer- This usually presents with blood in the urine. It’s higher risk in those over 50, or smokers. Gross blood in the urine should always be evaluated, but microscopic blood in this age and risk group should also be evaluated. Bladder cancer usually doesn’t cause pain, but can lead to OAB-type bladder symptoms.

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EmpowHER Guest

I am a 60 year old woman and I was diagnosed with interstitial cystitis and pelvic floor dysfunction 9 months ago and I finally think I have this figured out. I had 3 abdominal operations in my life.I've had 2 c-sections for breech births and I had an abdominal hysterectomy to remove a 6 month size uterine fibroid from me.I have excruciating pelvic pain and I'm getting worse instead of better. I'm going to pelvic floor physical therapy and do my exercises every day. In fact, I sometimes can't even walk anymore. My life is slipping away from me. Please advise me !

September 2, 2018 - 8:11pm
Expert HERWriter Guide Blogger

Thank you for this comprehensive look at Interstitial Cystitis. I know several women dealing with this condition right now. The information on common diagnoses that IC can mimic was very helpful too.

October 1, 2009 - 5:38pm
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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