Alphabetical list:

A B C D E F G H I J K L M N O P R S T U V W X Y Q Z 1 2 3 4 5 6 7 8 9

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Diagnosis


Diagnosis has been greatly simplified in recent years with the development of two new methodologies. The Pelvic Pain Urgency/Frequency (PUF) Patient Survey, created by C. Lowell Parsons, is a short questionnaire that will help doctors identify if pelvic pain could be coming from the bladder. The KCl test, also known as the potassium sensitivity test, uses a mild potassium solution to test the integrity of the bladder wall. Though the latter is not specific for IC/PBS, it has been determined to be helpful in predicting the use of compounds, such as pentosan polysulphate, which are designed to help repair the GAG layer. The previous gold standard test for IC/PBS was the use of hydrodistention with cystoscopy. Researchers, however, determined that this visual examination of the bladder wall after stretching the bladder was not specific for IC/PBS and that the test, itself, can contribute to the development of small glomerulations (that is, petechial hemorrhages) often found in IC/PBS. Thus, a diagnosis of IC/PBS is one of exclusion, as well as a review of clinical symptoms.

In 2006, the ESSIC society proposed more rigorous and demanding diagnostic methods with specific classification criteria so that it cannot be confused with other, similar conditions. Specifically, they require that a patient must have pain associated with the bladder, accompanied by one other urinary symptom. Thus, a patient with just frequency or urgency would be excluded from a diagnosis. Secondly, they strongly encourage the exclusion of confusable diseases through an extensive and expensive series of tests including (A) a medical history and physical exam, (B) a dipstick urinalysis, various urine cultures, and a serum PSA in men over 40, (C) flowmetry and post-void residual urine volume by ultrasound scanning and (D) cystoscopy. A diagnosis of IC/PBS would be confirmed with a hydrodistention during cystoscopy with biopsy.

They also propose a ranking system based upon the physical findings in the bladder. Patients would receive a numeric and letter based score based upon the severity of their disease as found during the hydrodistention. A score of 1-3 would relate to the severity of the disease and a rating of A-C represents biopsy findings. Thus, a patient with 1A would have very mild symptoms and disease while a patient with 3C would have the worst available symptoms.

In 2009, Japanese researchers identified a urinary marker called phenylacetylglutamine that could be used for early diagnosis.


Other articles from the section: Interstitial cystitis

Treatment - medication (bladder instillations)

  DMSO, a wood pulp extract, is the only approved bladder instillation for IC/PBS yet it is much less frequently used in urology clinics. Research studies presented at recent conferences of the American Urological Association by C. Subah Packer have demonstrated that the FDA approved dosage of a 50% solution of DMSO had the potential of creating irreversible muscle contraction. However, a lesser solution of 25% ...

Section: Interstitial cystitis

Treatment - pelvic floor treatments

  Work by Wise and Anderson (see details) has shown that urologic pelvic pain syndromes, such as IC/PBS and CP/CPPS, may have no initial trigger other than anxiety, often with an element of Obsessive Compulsive Disorder or other anxiety-spectrum problem. This is theorized to leave the pelvic area in a sensitized condition resulting in a loop of muscle ...

Section: Interstitial cystitis

Treatment - medication (pentosan polysulfate)

  Oral pentosan polysulfate (Elmiron) is believed to provide a protective coating in the bladder, but studies show it is not statistically significant compared to placebo. However, some studies have found that a minority of patients do respond to pentosan polysulfate.    

Section: Interstitial cystitis

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