Interstitial Cystitis

Urinating with urgency and pain are the main symptoms of interstitial cystitis, a disorder that affects mostly middle-aged women, a sector of the population that faces significant ignorance about this disease.

According to urologist in Noida, Interstitial cystitis (IC) is a chronic, rare and especially female disease (80% of cases are women), although men can be affected by a very similar pathology, prostatodynia. Although a good part of the population is aware of the problems that affect many men due to the prostate, the same is not true for women who suffer from this type of cystitis. With a peremptory and very frequent need to urinate, its problem is unknown even by the doctors themselves. And it is still having not been able to find out what are the causes that trigger it. At this time, one of the main hypotheses that is defended is that bad voiding habits, such as holding too much urine, may favour its appearance.

When cystitis is mentioned, it is almost always associated with bacterial bladder inflammation, in which the germ Escherichia coli is the most frequent cause. But other causes of bladder irritation that are not bacterial also coexist, but respond to factors such as irradiation, chemotherapy or obstruction. A separate mention deserves the chronic cystopathies, which are that cystitis without known cause. This group includes interstitial cystitis, which in the US affects more than 700,000 people, according to data from the Interstitial Cystitis Association., however, there is no epidemiological data on its incidence, explains urologist in Greater Noida.

Cystitis, colloquial name for which this disease is known, refers to a chronic inflammation of the bladder wall. On the other hand, the interstitial surname is related to the network of cells that form collagen fibres and, in turn, to the intercellular space called interstitium, which is the part that becomes inflamed and irritated. This is because certain chemical components of urine, such as potassium, can pass through the layer that lines the inside of the bladder (the urothelium) and irritate the interstitium. Consequently, affected people suffer pain every time the bladder filling occurs, explains urologist in Sector 93 Noida.

It must also be borne in mind that interstitial cystitis is included within the so-called “painful bladder syndrome”, referring to any pathology related to pain of the organ in question. All ICs are painful bladders, but not all painful bladders are IC. For this reason, before a painful bladder picture, interstitial cystitis is diagnosed when no organic cause is seen, such as a bladder tumour, stones (or stones) in the urinary tract or a urinary infection that justifies that pain. After discarding these organic causes and carrying out a series of tests, and provided that the patients meet certain clinical criteria, the professionals in urology reach the conclusion that they are facing a specific clinical picture: IC.

Discomfort

The symptoms that lead to seeing the urologist in Ghaziabad focus on the urgency to urinate and a frequency that results in going to the bathroom every 10 to 15 minutes, very strong bladder pain in the perineal area and much stinging in the form of burning continued.

The suffering is such that as soon as the first symptoms appear, the affected women decide to consult a specialist, although they often miss the professional to go to. Since the discomforts are in the area of ​​the genitals, they go to the gynaecologist, or, because they can be confused with a urine infection, they also turn to the general practitioner. Then start a pilgrimage to find the specialist who can diagnose and treat this problem properly: the urologist, says best urologist in Noida.

The diagnosis is made to wait

At first, the symptoms of IC can be confused with those of a cystitis of bacterial origin, so it is usually treated with antibiotics. When it is observed that they do not respond to the treatment, other analytics are practiced verifying that the infection is not caused by bacteria. The same happens with men, since prostatidynia can be confused with an infectious prostatitis, says best urologist in Ghaziabad.

In order to arrive at the diagnosis, the most important thing, in either case, is for the urologist in Vaishali to interpret and create what the patient is explaining to him, since the symptomatology of the IC is very varied and subjective; each person feels the pain with different intensity.

Until it is concluded that it is an interstitial cystitis, those affected have had to undergo several tests:

• Cystoscopy using an endoscope to examine the inside of the bladder.
• Functional urodynamics, based on filling the bladder to reproduce the symptoms that the patient explains and study if it hurts and check the symptoms that it has.
• The biopsy, in which a sample of tissue is taken to make a pathological analysis.

In addition, the same surgical act can be used to carry out a bladder hydrodisstination against chronic pelvic pain. This treatment consists of filling the bladder above its capacity and keeping it at that pressure between 5 and 10 minutes. A manoeuvre that allows patients to feel some improvement, although this is variable, depending on each person. Its duration is variable: between three and four months up to a year, after which it must be repeated. The result depends on the previous symptomatology, says best urologist in Greater Noida.

It is common for those affected to encounter long waiting lists for the first visit to the urologist. For this reason, since this specialist receives them at the first visit until the diagnosis is established, a one-year period may elapse in the best of cases. In others, due to the initial confusion of the symptoms with those of an infection, both they and they can live for some years with an incorrect diagnosis.

Treatment without cure

Currently, the IC has no cure and those affected cannot find another option but to learn to live with it for the rest of their lives, explains best urologist in Vaishali. However, there are several therapeutic routes that, prescribed and applied by an expert urologist in this pathology, allow controlling symptoms in 70% of patients, although they must be aware of the chronic nature of the disease and maintain realistic expectations.

• Drugs: Treatment begins in a staggered fashion, with anti-inflammatories to reduce inflammation and anticholinergics to relax the bladder. Sometimes, anxiolytic or antidepressant drugs are also administered, but not because of anxiety or depression, but because the pain can generate a great sensation of anxiety. In this case, the goal is to get the patient to relax and break the circle of pain. When patients do not improve with these treatments, analgesics can be administered as a means of protection against harmful agents and in order to reduce the intensity of symptoms.
• Neuromodulation This treatment, hitherto applied to the spine, consists in the placement of an electrode in the sacral root 3 that collects the afferents (the afferent nerves transport sensory signals from the organs to the brain) of the bladder. This electrode is a kind of pacemaker that, with electrical stimuli, orders the sensations of patients with respect to the bladder. Initially, it is placed for a variable time of 15 days and a month, time in which you can lead a normal life. The patient who follows it must also fill in a voiding schedule prior to the placement of the electrode and another afterwards. In this way, it is checked whether it has improved or not. In the affirmative case, the device will be permanently implanted.
• Other treatments: Some affected also resort to treatments such as physiotherapy since it is proven that certain massages on the muscles of the area work in some women and even go to the support of a therapist due to the impact that the IC can have on the well-being mental of those affected.

A vital turn

According to urologist in Sector 108 Noida, the daily life of a person diagnosed with Interstitial Cystitis takes a 180 degree turn in many cases, since it affects daily, work and couple life in several aspects:

• In day to day. Frequent urination, accompanied by pain, prevents many of those affected from going shopping, traveling, going for a walk or to the movies. Once the disease manifests itself, women who suffer from it are aware of the shortage of public toilets in cities. To access one of them they must enter a bar or restaurant and pay a drink, which is unfeasible for the pocket every quarter hour. In addition, frequent drinking is counterproductive for them because it accelerates the urge to urinate urgently. Trying to endure produces pain and wearing a diaper to hold the urine, a great stinging.
• At work. The working life of some of those affected ends when the disease begins. The displacements to the workplace, meet a set schedule and perform as one more becomes a very difficult task because the urgent urge to urinate and pain prevent meet all requirements. Depending on the level of the disease, some affected have achieved a certain degree of work disability, even absolute.
• Sex life and couple. This area also suffers considerably. Inflammation of the bladder, accompanied by pain and stinging, radiates to the genital area of ​​the woman and prevents her, on numerous occasions, from having sexual intercourse without pain. The inflamed bladder feels like a rock that bothers enormously. A fact that can generate conflicts of couple and even reach separation.

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