Briefly about interstitial cystitis/bladder pain syndrome (IC/BPS)

• Frequent urinary urgency
• The volume of the voided urine (per occasion) is small
• Pain that affects the bladder, the urethra, the vagina and/or the pelvic floor
• Sudden uncontrollable urinary urge
• The symptoms may suddenly worsen (flare up) due to external factors, such as consuming certain food groups, stress etc.

It is essential to be pointed out that the symptoms described above may refer to several other conditions, such as an acute urinary tract infection. Thus, the first step of the diagnosis has to be the exclusion of these conditions.

Nevertheless, the cause of the symptoms, the deficiency of the GAG-layer can be identified. The increased permeability of this layer leads to the typical symptoms. The test is based on a special, 2-day voiding diary. It is worth noting that IC/BPS is not the only condition in which the GAG-layer can be deficient.

Although there is no known permanent cure for the condition, patients can be symptom-free for a long period of time – even years! – assuming the proper treatment is being applied.

The therapy must always be tailored to the patient; everything depends on the symptoms and examination results, including the special voiding diary. For the best response, it is worth starting with a combined therapy. In case of mild symptoms, this includes diet, abundant fluid intake and oral medication of anti-inflammatories and GAG-layer components.

If there is severe pain, major GAG-layer deficiency the symptoms are worsening in spite of the oral therapy, or the cystoscopy image reveals characteristic areas of bleeding or disrupted urothelial tissues, the treatment is to be complemented with locally administered medication. This means a medicine cocktail instilled directly into the bladder. If there is no improvement – or there are major lesions in the bladder wall –, hydrodistension of the bladder followed by the fulguration of the affected areas may help.

Tailoring the described options to the patient, the quality of life can be raised to a comfortable level in most cases – even a fully symptom free status can be achieved.