How common is interstitial cystitis

Constant agony in the bladder

The urge to go to the toilet dominates everyday life. “Patients often need to go to the bathroom 30 times a day or more, but the relief is short-lived. They suffer from severe pain, which can radiate into the intestines, pelvic floor, genitals and the whole abdomen. ”The night's rest is considerably disturbed by the imperative to urinate. The functional bladder volume, i.e. the amount of urine that can be held, is significantly smaller than the anatomical organ volume.


The neuropathic pain is described as sharp, pointed and stabbing, explained the doctor, who heads the neuro-urology department at Marienhospital Herne, at the event supported by Medac GmbH. The chronic pain disorder drives many patients into depression. Sometimes the bladder even has to be completely or partially removed. In his experience, the disease usually begins between 40 and 45 years of age.


"Mucosal cracking" is typical


The exact causes of the complaints are unclear. According to one hypothesis, the persistent pain develops from bacterial cystitis, but this has not been proven. The doctor must first rule out other causes, for example bladder stones, infections with bacteria, fungi and viruses, genital herpes, bladder cancer or tuberculosis and, in men, prostatitis, said van Ophoven. "The finding of interstitial cystitis is a diagnosis of exclusion."


Ultimately, the diagnosis is made by a cystoscopy with overstretching of the urinary bladder; this is done under general anesthesia. When the filling medium is drained, the bladder mucous membrane ruptures and can bleed profusely. "This 'mucosal cracking' is typical of the disease."


The doctor can also take tissue samples during the examination. If the tears in the mucous membrane are scabbed with an electrocautery, many patients have fewer symptoms for a few weeks, explained van Ophoven. Then you have to repeat the procedure.


Inflammation in the bladder wall


In interstitial cystitis, the deeper spaces in the bladder wall are changed and inflamed. Apparently the mucous membrane of the urinary bladder plays an important role in the pathogenesis. It is believed that the protective glycosaminoglycan (GAG) layer on the urothelium is defective. Aggressive substances from the urine can come into direct contact with the bladder wall and trigger chronic inflammatory processes. The release of histamine from mast cells and a neurovegetative imbalance seem to keep the inflammatory processes going, said van Ophoven.