Comfora

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Clinical Picture in IC

Symptoms of Interstitial Cystitis

Interstitial cystitis (IC) initially presents with a subacute onset followed by a rapid peak in severity of symptoms. The plateau phase which follows the rapid peak is characterised by exacerbations and remissions of symptoms.

The symptoms of IC are listed below:

  • Urinary sensory urgency with or without pain, pressure or spasm
  • Urinary frequency
  • Vague sense of incomplete bladder emptying
  • Increase in nocturnal frequency with progression of the disease
  • Suprapubic pain radiating to low back and thighs; aggravated by full bladder and relieved after bladder emptying
  • An average rate of voiding of 16 times per day
  • Associated medical conditions such as allergies, irritable bowel syndrome and fibromyalgia
  • Emotional and psychological overlap in the complaints
  • Complaint of incontinence is rare
  • Dyspareunia and decreased libido1-3

Flares in IC

The progression of disease in IC undergoes episodes of exacerbations and remissions. Around 50% of the patients show a spontaneous remission after a few months. The patients may be completely asymptomatic intermittently with acute episodes of flares. In some, the disease may have a progressive course with gradual increase in symptoms over several years. Some of the precipitating factors responsible for intermittent flares are as follows: 2

  • Emotional or physical stress
  • Muscle and joint pain, migraines, allergic reactions, and gastrointestinal problems
  • Premenstrual period
  • Consumption of specific foods such as coffee, alcohol, carbonated drinks, citrus, tomatoes and chocolates 3

Symptoms of IC in Women

The symptoms of IC in women overlap with symptoms of urinary tract infection, chronic urethral syndrome, vulvodynia, overactive bladder and endometriosis. The common symptoms seen in women with IC are as follows:

  • Urinary frequency, urgency and nocturia
  • Dyspareunia (common in 50% of patients)
  • Fluctuations in symptoms relative to ovulatory cycle
  • Remission of symptoms during second and third trimester of the disease 1,2,4,5

Symptoms of IC in Men

The symptoms of IC in men overlap with the symptoms of prostatitis which is characterised by similar symptoms and single pathophysiological process in the lower urinary tract. The symptoms seen in male patients with IC are as listed below:

  • Urinary urgency and frequency
  • Nocturia
  • Perineal, groin, penile or scrotal pain
  • Pain at locations throughout the pelvis during sexual intercourse 1,2

References
  1. Evans RJ. Pathophysiology and clinical presentation of interstitial cystitis. Avd Stud Pharm. 2005;8-14.
  2. Heck BN. Interstitial cystitis:Enhancing early identification in primary care settings. JNP. 2007;3(8):509-519.
  3. Panzera AK. Interstitial cystitis/Painful bladder syndrome. Urol Nurs. 2007;27(1):13-19.
  4. Bogart LM, Berry SH, Clemens JQ. Symptoms of interstitial cystitis, painful bladder syndrome and similar diseases in women: A systematic review. The Journal of Urology. 2007;177(2):450-456.
  5. Parsons CL, Albo M. Intravesical potassium sensitivity in patients with prostratis. J Urol. 2002;168(3):1054-1057.