1. Is biopsy routinely recommended in a case of IC?

Biopsy is a non mandatory test in the primary diagnosis of IC. It is only indicated in the presence of a high index of suspicion for malignancy, premalignant lesions and other varieties of cystitis.

2. What are the biopsy findings in a patient with IC?

Biopsy in a case of classical IC shows transmural involvement of the bladder wall with inflammatory changes, granulation tissue, mast cell infiltration and fibrosis. However there are no remarkable findings during biopsy in patients with non ulcerative type of IC.

3. Does the potassium sensitivity test give rise to false positive results?

Yes. False positive results are seen in patients with urinary tract infections and radiation cystitis

4. What are the urodynamic findings in patients with IC?

Patients with IC show symptoms of pain with bladder filling and a small volume void sensation during cystometrogram (CMG). However, a reduction in bladder capacity is only noted in advanced cases of IC. Bladder compliance, volitional bladder contractions, pressure flow studies and uroflow studies are normal in patients with IC.

5. What is the most important tool in the assessment of IC?

Cystoscopy is the most important tool in the assessment of patients with IC. The diagnostic findings are diminished bladder capacity under anaesthesia and evidence of Hunner's ulcer.

6. What is the advantage of the new intravesical anaesthetic challenge test?

This relatively new diagnostic test may help in identifying bladder as the source of pain in patients presenting with symptoms of IC. It is based on the principle that the instillation of an anaesthetic lidocaine/bicarbonate solution in the bladder of a patient with IC would result in reduction of pain.

7. What is the role of clinical markers such as proteoglycans and antiproliferative factor in IC?

A. Markers reflect the effects of the underlying disease process. They enable an early identification, early intervention and delay in progression of the disease. They could be beneficial in differentiating IC from other diseases with overlapping symptoms.

8. What is the mechanism of action of the oral drug pentosan polysulphate in IC?

Though its mechanism of action largely remains unclear, it promotes restoration of the defective layer, thereby, preventing further urothelial insult.

9. Which are the most common FDA approved drugs used in IC?

Pentosan polysulphate is the most commonly used oral drug and dimethyl sulphoxide is the most common intravescial drug used in IC.

10. What is the recent in the management of IC?

A recent development in the management of IC is simultaneous use of oral and intravesicular pentosan polysulphate. A recently conducted study showed the combination to be a safe and effective therapeutic option and reduce severity of IC symptoms, thereby, improving the quality of life and well-being.