Interstitial Cystitis (cont.)

IC is often diagnosed after other conditions are ruled out because there is no test specifically for IC. On average, people with IC experience symptoms for four years before the condition is diagnosed.

Because the symptoms of IC are similar to those of other disorders of the urinary system, the first step is to rule out other diseases before considering a diagnosis of IC. Other possible causes for the symptoms include the following:

• Urinary tract infections
• Bladder cancer
• Tuberculous cystitis
• Radiation cystitis
• Sexually transmitted diseases
• Kidney stones
• Vaginal infections
• Endometriosis
• Prostatitis
• Overactive bladder (OAB)
• Neurogenic bladder (bladder symptoms caused by a neurologic disease)

Tests that help to rule out these other conditions include the following:

• Urine culture: This test can be used to identify the organisms that cause urinary tract infections. For this exam, a midstream specimen of urine is obtained in a sterile container after the genital area is washed. In people with IC, the urine is sterile and no bacterial growth is obtained.
• Cystoscopy with distention of the bladder: If no infectious agent is identified in the urine, cystoscopy is performed. In this procedure, the health-care provider uses a cystoscope (a hollow tube with a light source) to see the inside of the bladder. The bladder wall is stretched by filling it with liquid or gas. This procedure may be performed under anesthesia because it may be painful. People with IC may have pinpoint hemorrhages, called glomerulations, in the bladder wall and/or ulcers (an open sore in the lining of the bladder), which can be viewed during the procedure.
• Biopsy of the bladder wall: A sample of the bladder wall tissue is removed for microscopic examination. This test also helps to rule out bladder cancer.
• Potassium sensitivity test: In this test, the urinary bladder is filled with either potassium solution or water, and pain and/or urgency scores are compared. A person who has IC feels more pain and/or urgency when the bladder is filled with the potassium solution than when the bladder is filled with water. However, people with normal bladders cannot tell the difference between the two solutions.