Diseases

Painful bladder syndrome (also called Interstitial cystitis) is a notoriously difficult condition to treat. The symptom complex is one of pain associated with the bladder, pelvic pain, urinary frequency and vaginal pain or vaginismus in women. There is no specific diagnostic test. Diagnosis hinges on detailed clinical evaluation and exclusion of other causes of pain. Patients will often be asked to fill questionnaires regarding their problem or may be asked to prepare diary records. Some patients may undergo urodynamics, imaging and cystoscopy with bladder distension and evaluation of bladder wall changes. A biopsy may also be taken from the bladder. Treatment is complex and no single treatment works for all patients. A step-wise approach consists of oral medication, hydrodistension of the bladder under anesthesia and periodic instillation of medication into the bladder. For patients who fail to respond to these therapies, botulinum toxin injections into the bladder or surgical treatment may rarely be required.