Seeking A Rational Approach to the Diagnosis and Treatment of Interstitial Cystitis.

At least 90% of the half-million Americans with interstitial cystitis (IC) are women. But correctly diagnosing and treating the problem are not as clear as the statistics. The clinical hallmarks--bladder pain, urinary urgency and frequency, nocturia, and dysuria--are not confined to IC. A key feature of diagnosing the problem is to exclude the vast array of other possibilities, including carcinoma and detrusor hyperreflexia. To confirm the diagnosis, cystoscopic exam with hydrodistention is needed to visualize diffuse glomerulations or classic Hunner's ulcer. Treatment is empiric and can involve a variety of oral and intravesical therapies. Patients with a bladder capacity less than 250cc may benefit from surgery.