Question

Dr. Burks, what is the difference between abacterial/noninfectious cystitis and IC? Is it the same ?? I did a cystoscopy with hydrodistention and I have a low grade chronic inflammation of the bladder wall (because of holding my urine in for a long time 2 years ago), no mast cells, no glomerulations, but all the symptoms (urgency, frequency, pain in the bladder, nocturia 1 time/night)...  Ive read that abacterial cystitis can be cured...Thank you..

[David A Burks, MD]

Hi Again,

There are multiple types of cystitis.  The most common type is acute bacterial cystitis, the common bladder infection wemen get all the time.  Patients can get a chronic bacterial cystitis where there is a deep infection in the bladder wall below the surface.  Antibiotics in the urine can't easily clear this infection due to it's deep position in the bladder.  It usually takes many weeks to months of antibiotics to clear the infection and it can certainly cause persistent bladder symptoms.  An abacterial /noninfectious cystitis is a general term for a number of disorders where the bladder is inflammed but not infected with bacteria.  Radiation damage to the bladder during treatment for pelvic cancers can cause radiation cystitis.  Certain chemotherapy drugs can cause a chemical cystitis.  Interstitial cystitis is in the category of nonbacterial cystitis caused by an inflammation in the bladder wall. Cure for abacterial cystitis required long time therapy and the response to treatment is usually poor. There is often a thin line separating a chronic cystitis from interstitial cystitis making it hard to tell what you really have.  Good Luck

[elena84]

So what should I do now? How will I know what therapy I should try?? (or how will the doctor now what to do?)...For abacterial cystitis or IC?? Will Cystistat instillations help??? Does it restore the bladder wall only temporarily ??? So I ve read...

[David A Burks, MD]

You most likely have Interstitial cystitis.  About 20% of patients with IC have no glomerulations or ulcers in their bladder on a cystoscopy and hydrodistention but have the classic symptoms.. Chronic inflammation is what you see in IC bladders when you do a biopsy. Cystistat is generally ineffective.  Consider lidocaine bladder instillations to help relieve IC flares. If it works, I have patients instilling it into their bladder at home daily.

[gypsycarla]

A related discussion, Should I go back to DR was started.