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Treatment of Interstitial Cystitis (Bladder Pain Syndrome)

Multimodal therapy approach for chronic painful bladder syndrome.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kadın Hastalıkları ve Doğum department. Book Appointment →

What is Treatment of Interstitial Cystitis (Bladder Pain Syndrome)?

Interstitial cystitis (IC) / bladder pain syndrome (BPS) is a chronic syndrome characterised by suprapubic pain associated with bladder filling lasting more than six weeks, urgency, frequency and nocturia, with no demonstrable infection or other identifiable cause. It is more common in women (5-10:1).

Pathophysiology is multifactorial: GAG layer (glycosaminoglycan) defect, neurogenic inflammation, mast cell activation, urothelial dysfunction and central sensitisation. The Hunner lesion (classic IC) is detected by cystoscopy in 10% of cases and represents a more serious form of the disease.

Diagnosis is clinical and based on exclusion. Treatment is stepwise (AUA guidelines): conservative measures (diet, behavioural change, physiotherapy), oral medications (amitriptyline, hydroxyzine, pentosan polysulfate), intravesical therapies (DMSO, heparin, lidocaine), neuromodulation (sacral neuromodulation), and surgery (cystectomy + urinary diversion) for refractory cases. Multidisciplinary management is critical for success.

Symptoms

Suprapubic pain (filling-related)
Increased urinary frequency
Urgency
Nocturia
Pelvic pain
Sexual dysfunction (dyspareunia)
Pain reduction with voiding
Symptom flare with stress

Risk Factors

Female gender
Middle age
Pelvic surgery history
Sexual abuse history
Other chronic pain conditions (fibromyalgia, IBS)
Allergic conditions
Autoimmune diseases
Stress

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent suprapubic pain
  • Bladder symptoms with negative culture
  • Significant impact on quality of life
  • Pain unresponsive to medications
  • Sleep disturbance
  • Sexual dysfunction
  • Pelvic pain
  • Symptom flare

Treatment Methods

01
Diagnostic evaluation (urine culture, cystoscopy)
02
Diet modification (acidic, spicy avoidance)
03
Bladder training and behavioural modification
04
Pelvic floor physiotherapy
05
Oral medications (amitriptyline, hydroxyzine, pentosan polysulfate)
06
Intravesical therapies (DMSO, heparin, lidocaine)
07
Hydrodistention and Hunner lesion fulguration
08
Sacral neuromodulation, refractory surgery

Which Department to Visit?

You can visit our Kadın Hastalıkları ve Doğum department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kadın Hastalıkları ve Doğum Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.