Not Just Simple Cystitis!... It Could Be Interstitial Cystitis

A woman in her 40s, identified as Ms. A, was diagnosed with cystitis several times and took antibiotics, but her symptoms repeatedly improved and relapsed, showing no improvement for several months.

Having frequently experienced cystitis, she considered herself to have a "sensitive bladder," and often did not visit the hospital unless her symptoms were severe. She also sometimes took previously prescribed medication on her own initiative.

However, recently, even a small amount of urine in her bladder caused her to experience severe pain, significantly disrupting her daily life. She eventually visited a urology clinic and, after a thorough examination, was diagnosed not with acute bacterial cystitis, but with "interstitial cystitis (IC)."

Lower abdominal pain. Provided by Clipart Korea (Not related to the report)

Generally, when people think of "cystitis," they first imagine acute bacterial cystitis caused by bacterial infections such as Escherichia coli.

In this condition, bacteria that enter the bladder through the urethra cause inflammation, leading to symptoms such as pain during urination, frequent urination, discomfort in the lower abdomen, and hematuria. It is diagnosed through urine tests and urine cultures, and in most cases, symptoms improve with antibiotic treatment.

In contrast, interstitial cystitis is a disease in which chronic pain and voiding dysfunction are caused by a combination of factors, including dysfunction of the bladder mucosa, nerve hypersensitivity, and immunological factors, rather than bacterial infection.

The surface of the bladder is protected by a GAG (glycosaminoglycan) layer, which prevents microorganisms or irritants in the urine from penetrating the bladder wall. In patients with interstitial cystitis, this protective layer is weakened or damaged, allowing irritants to penetrate the bladder tissue and cause inflammation and pain.

The characteristic feature of interstitial cystitis is that pain worsens as the bladder fills and is temporarily relieved after urination. Pain may be felt in the suprapubic area, lower abdomen, perineum, or vagina, and symptoms such as frequent urination during the day and night, urgency, and dyspareunia may also occur.

Diagnosing interstitial cystitis is difficult based solely on symptoms. A diagnostic process is required to exclude other conditions such as bacterial cystitis, urinary stones, and overactive bladder. This includes urine tests, urine cultures, blood tests, pelvic CT scans, bladder ultrasounds, and, in men, prostate examinations.

Cystoscopy may reveal ulcerative lesions known as Hunner's ulcers or glomerulation, which are pinpoint hemorrhages in a net-like pattern on the bladder mucosa. These findings are important reference points for diagnosing interstitial cystitis.

Treatment for interstitial cystitis focuses on alleviating symptoms and improving quality of life. Bladder training can help increase bladder capacity and extend intervals between urination. Patients are advised to avoid foods that may irritate the bladder, such as caffeine, alcohol, and chocolate. Depending on the patient's condition, medications to protect the bladder mucosa and relieve pain may also be prescribed.

Pelvic floor muscle strengthening exercises (Kegel exercises), gentle yoga, and stretching are effective for improving bladder function and reducing stress, while exercises that put impact on the pelvis, such as running, should be avoided.

Seo Yeongeun, Chief of Urology at Daedong Hospital (urology specialist), stated, "Voiding dysfunction may seem like a minor inconvenience, but it can be a signal of internal abnormalities." She emphasized, "Especially for chronic diseases such as interstitial cystitis, symptoms progress gradually and appear in various forms, so it is essential to receive an accurate diagnosis and systematic treatment plan from a urology specialist rather than self-diagnosing or taking medication arbitrarily."

She added, "Taking an active approach in the early stages can help prevent symptom aggravation and greatly aid in the recovery of daily functioning."

If you experience voiding dysfunction to the extent that it affects your daily life?such as frequent urge to urinate, difficulty holding urine, sleep disturbances due to nocturia, hematuria, lower abdominal pain, or pain during urination?you should visit a urology clinic for a proper diagnosis.

This content was produced with the assistance of AI translation services.