Interstitial cystitis (IC) (synonyms: Bladder pain syndrome; chronic interstitial cystitis; Hunner’s cystitis; Hunner’s variant; interstitial cystitis; nonbacterial cystitis; abacterial cystitis; painful bladder syndrome; Engl. bladder pain syndrome (BPS); ICD-10-GM N30.1: Interstitial cystitis (chronic)) is a chronic inflammation of the bladder wall layers that is abacterial (not bacterial). In this case, there has been persistent urogenital pelvic pain for more than six months. In addition, there is at least one accompanying urinary bladder symptom such as alguria (pain when urinating) or pollakiuria (frequent urination without increased urination).
Affected individuals may need to urinate up to 60 times per day. After urination, the pain in the lower abdomen improves only for a short time.
Taking into account the pathological (pathological) changes, the following types of interstitial cystitis are distinguished:
- Hunner type with Hunner lesions – ulcerative form; in about 10% of cases; usually affected persons are 10 years older than those of the non-Hunner type.
- Non-Hunner type – non-ulcerative form.
Sex ratio: males to females is 1: 5-8.
Frequency peak: diagnosis is usually made in the 4th decade of life.
The disease is very rare. It is estimated that seven patients with corresponding symptoms come to a family doctor / internist practice in a year. The prevalence (disease frequency) for women is 52-500 per 100,000 inhabitants (Germany).
Course and prognosis: Since interstitial cystitis is a rather unknown clinical picture and can be confused with many other clinical pictures, especially urinary tract infection (UTI) or urinary incontinence (bladder weakness), it takes on average 9 years from the initial symptoms to the diagnosis. By then, sufferers have gone through a long ordeal. Ultimately, interstitial cystitis is a diagnosis of exclusion.Interstitial cystitis is slowly progressive (progressive). Initially, symptoms are mild but increase in intensity over time. In women, symptoms worsen about a week before the onset of menstruation. Sexual activity also increases the symptoms. The emotional state of the affected person can lead to both flare-ups and remission (regression). In advanced stages, ulceration (ulceration) of the bladder wall and shrinkage of the bladder occur.The disease is associated with significant limitations that affect all areas of life. For example, restful sleep is not possible because of the urge to urinate, even at night. Rapid therapeutic success is not to be expected. A causal therapy is not yet possible. The main focus of treatment is pain relief.
Note: Due to the protracted course of the disease, psychological/psychiatric care is recommended (S2k guideline: target recommendation.
Guideline
- S2k guideline: diagnosis and therapy of interstitial cystitis. (AWMF register number: 043-050), September 2018 long version.
