Skip to main content

Advertisement

Log in

Interstitial cystitis: The painful bladder syndrome

  • Published:
Current Review of Pain Aims and scope Submit manuscript

Abstract

Interstitial cystitis (IC) is an enigmatic and frustrating condition to manage as a physician and to cope with as a patient. Many patients are declared as drug addicted and neurotic. Social status and number of sexual partners showed no correlation with incidence. Patients report moderate to excruciating pain in the suprapubic or vaginal area, urgency and frequency (up to 50 micturitions/d), and disruption of their social life. Diagnosis of IC is made by exclusion. Different pathophysiologic mechanisms have been proposed: changes in epithelial permeability, pelvic floor dysfunction, mastocytosis, activation of c-fibers, and increase of nerve growth factors and bradykinin. No single theory can explain IC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. Bourque JP: Surgical management of the painful bladder. J Urol 1951, 65:25–35.

    CAS  PubMed  Google Scholar 

  2. Rosenthal RH: Psychology of chronic pelvic pain. Obstet Gynecol Clin North Am 1993, 20:627–641.

    CAS  PubMed  Google Scholar 

  3. Elliott MI: Chronic pelvic pain. What are the psychological considerations? Am Pain Soc Bull 1996, 6:1–4.

    Google Scholar 

  4. Oravisto KJ: Epidemiology of interstitial cystitis. Ann Chir Gynaecol 1975, 64:75–77.

    CAS  Google Scholar 

  5. Held PJ, Hanno PM, Wein AJ, et al.: Epidemiology of interstitial cystitis. In Interstitial Cystitis. Edited by Hanno PN et al. London: Springer Verlag; 1990:29–48.

    Chapter  Google Scholar 

  6. Curhan GC, Speizer FE, Hunter DJ, et al.: Epidemiology of interstitial cystitis: a population based study. J Urol 1999, 161:549–552.

    Article  CAS  PubMed  Google Scholar 

  7. Ratner V: Pain in interstitial cystitis, changing attitudes, changing treatments. Pain Forum 1999, 8:154–157.

    Article  Google Scholar 

  8. Koziol JA: Epidemiology of interstitial cystitis. Urol Clin North Am 1994, 21:7–20.

    CAS  PubMed  Google Scholar 

  9. Koziol JA, Clark DC, Gittes RF, et al.: The natural history of interstitial cystitis: a survey of 374 patients. J Urol 1993, 149:465.

    CAS  PubMed  Google Scholar 

  10. Bauer SB: Campbell’s Urology, edn 7. Edited by Walsh PC et al. Philadelphia: W. B. Saunders; 1998:2019–2053.

    Google Scholar 

  11. Hand JR: Report of 223 cases (204 women and 19 men). J Urol 1949, 61:291–310.

    CAS  PubMed  Google Scholar 

  12. Wiesman MH, McDonald EC, Wilson CB: Studies of the pathogenesis of intertitial cystitis, obstructive uropathy, and intestinal malabsorption in a patient with systemic lupus erythematosus. Am J Med 1981, 70:875–881.

    Article  Google Scholar 

  13. Meulders Q, Michel C, Marteau P, et al.: Association of chronic interstitial cystitis, protein losing enteropathy and paralytic ileus with seronegative systemic lupus erythematosus. Clin Nephrol 1992, 37:239–244.

    CAS  PubMed  Google Scholar 

  14. Alagiri M, Chottiner S, Rattner V, et al.: Interstitial cystitis: unexplained association with other chronic disease and pain syndromes. Urology 1997, 49:52–57.

    Article  CAS  PubMed  Google Scholar 

  15. Clauw DJ, Schmidt M, Radulovic D, et al.: The relationship between fibromyalgia and interstitial cystitis. J Psychiatr Res 1997, 31:125–131.

    Article  CAS  PubMed  Google Scholar 

  16. Pang X, Marchant J, Sant GR, et al.: Increased number of substance P positive nerve fibres in interstitial cystitis. Br J Urol 1995, 75:744–750.

    Article  CAS  PubMed  Google Scholar 

  17. Gillenwater JY, Wein AJ: Summary of the national institute of arthritis, diabetes, digestive and kidney diseases workshop on interstitial cystitis. NIH, Bethesda, MD, August 28–29, 1987. J Urol 1988, 140:203–206.

    CAS  PubMed  Google Scholar 

  18. Wein AJ, Hanno PM, Gillenwater JY: Interstitial cystitis; an introduction to the problem. In Interstitial Cystitis. Edited by Hanno PM et al. London: Springer-Verlag; 1990:3–15.

    Chapter  Google Scholar 

  19. Hanno PM: The diagnosis of interstitial cystitis revisited: lessons learned from the national institute of health interstitial cystitis database study. J Urol 1999, 161:553–557. Highlights the problem that NIADDK criteria are too restrictive to be used by clinicians to give a dianosis of IC.

    Article  CAS  PubMed  Google Scholar 

  20. Warren JW: Interstitial cystitis as an infectious disease. Urol Clin North Am 1994, 21:31–39.

    CAS  PubMed  Google Scholar 

  21. Anderstrom CRK, Fall M, Johansson SL: Scanning electron microscopic findings in interstitial cystitis. Br J Urol 1989, 63:270–275.

    Article  CAS  PubMed  Google Scholar 

  22. Tait J, Peddie BA, Baily RR, et al.: Urethral syndrome (a bacterial cystitis) search for a pathogen. Br J Urol 1985, 57:552–556.

    Article  CAS  PubMed  Google Scholar 

  23. Hanash KA, Pool TL: Interstitial and hemorrhagic cystitis: viral, bacterial, and fungal studies. J Urol 1970, 104:705–706.

    CAS  PubMed  Google Scholar 

  24. Fall M, Johansson SL, Vahle A: A clinicopathological and virological study of interstitial cystitis. J Urol 1985, 133:771–773.

    CAS  PubMed  Google Scholar 

  25. Niku SD, Stein PC, Scherz HC, Parsons CL: A new method for cytodestruction of bladder epithelium using protamine sulfate and urea. J Urol 1994, 152:1025–1028.

    CAS  PubMed  Google Scholar 

  26. Ochs RL, Stein TW Jr, Peebles CL, et al.: Autoantibodies in interstitial cystitis. J Urol 1994, 151:587–592.

    CAS  PubMed  Google Scholar 

  27. Riedl CR, Knoll M, Plas E, Pfluger H: Electromotive drug administration and hydrodistention for the treatment of interstitial cystitis. J Endourol 1998, 12:269–272.

    Article  CAS  PubMed  Google Scholar 

  28. Schmidt RA: Pelvic floor behavior and interstitial cystitis. Semin Urol 1991, 9:154–159.

    CAS  PubMed  Google Scholar 

  29. DeGroat WC: Anatomy and physiology of the lower urinary tract. Urol Clin North Am 1993, 20:383–402.

    CAS  Google Scholar 

  30. Christmas TJ, Rode J, Chapple CR, et al.: Nerve fibre proliferation in interstitial cystitis. Virchows Arch A Pathol Anat Histopathol 1990, 416:447–451.

    Article  CAS  PubMed  Google Scholar 

  31. Aldenborg F, Fall M, Enerback L: Proliferation and transepithelial migration of mucosal mast cells in interstitial cystitis. Immunology 1986, 58:411–416.

    PubMed Central  CAS  PubMed  Google Scholar 

  32. Wesselmann U, Lai J: Mechanisms of referred visceral pain: uterine inflammation in the adult virgin rat results in neurogenic plasma extravasation in the skin. Pain 1997, 73:309–317. Demonstrates the phenomenon of referred pain.

    Article  CAS  PubMed  Google Scholar 

  33. Doggweiler R, Jasmin L, Schmidt RA: Neurogenically mediated cystitis in rats: an animal model. J Urol 1998, 160:1551–1556. The first model of neurogenically induced cystitis. The virus was found in the central nervous system but never in the bladder.

    Article  CAS  PubMed  Google Scholar 

  34. Levine JD, Moskowitz MA, Basbaum AI: The contribution of neurogenic inflammation in experimental arthritis. J Immunol 1985, 135(suppl 2):843s-847s.

    CAS  PubMed  Google Scholar 

  35. McGillis JP, Mitsuhashi M, Payan DG: Immunomodulation by tachykinin neuropeptides. Ann N Y Acad Sci 1990, 594:85–94.

    Article  CAS  PubMed  Google Scholar 

  36. Church MK, Lowman MA, Robinson C, et al.: Interaction of neuropeptides with human mast cells. Int Arch Allergy Appl Immunol 1989, 88:70–78.

    Article  CAS  PubMed  Google Scholar 

  37. Rosamilia A, Clements JA, Dwyer PL, et al.: Activation of the kallikrein kinin system in interstitial cystitis. J Urol 1999, 162:129–134.

    Article  CAS  PubMed  Google Scholar 

  38. McMahon SB: NGF as a mediator of inflammatory pain. Philos Trans R Soc Lond B Biol Sci 1996, 351:431–440.

    Article  CAS  PubMed  Google Scholar 

  39. Elbadawi A: Interstitial cystitis: a critique of current concepts with a new proposal for pathologic diagnosis and pathogenesis. Urology 1997, 49(suppl 5A):14–40.

    Article  CAS  PubMed  Google Scholar 

  40. Reiter RC, Gambone JC: Nongynecologic somatic pathology in women with chronic pelvic pain and negative laparoscopy. Reprod Med 1991, 36:253–259.

    CAS  Google Scholar 

  41. Zermann DH, Ishigooka M, Doggweiler R, Schmidt RA: Neurourological insights into the etiology of genitourinary pain in men. J Urol 1999, 161:903–908.

    Article  CAS  PubMed  Google Scholar 

  42. Shaker HS, Hassouna M: Sacral nerve root neuromodulation: an effective treatment for refractory urge incontinence. J Urol 1998, 159:1516–1519.

    Article  CAS  PubMed  Google Scholar 

  43. Ratner V, Slade D, Greene G: Interstitial cystitis. A patient’s perspective. Urol Clin North Am 1994, 21:1–5.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Doggweiler-Wiygul, R., Blankenship, J. & MacDiarmid, S.A. Interstitial cystitis: The painful bladder syndrome. Current Review of Pain 4, 137–141 (2000). https://doi.org/10.1007/s11916-000-0048-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11916-000-0048-9

Keywords

Navigation