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Urology (Expert Forum)
Re: Do I have IC?
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Re: Do I have IC?
by hfhs M.D.-AK, Jan 01, 1995 12:00AM
Posted By HFHS M.D.-AK on September 01, 1998 at 11:08:23:
In Reply to: Do I have IC? posted by Kate on August 27, 1998 at 05:10:16:
I have had an 8 year history of bladder problems. It started with cystitis after sexual intercourse years ago. I was put on antibiotics to take at "risk" times and kept this up for years. About 4 years ago I came down with a bladder inflammation which was confirmed by a cystoscopy. This took about 3 months to heal. I found that as time went by the antibiotics grew stronger and I had to take them longer to keep infection away. About 11 weeks ago while taking Ciproxin I felt I was getting cystitis (frequent urinating and no relief afterwards) I also felt as though I was going to "wet" myself. After a visit to my Urologist my antibiotics were changed from Ciproxin to Nitrofurantoin and the problem immediately became worse. I changed medictaion to Noroxin. It seemed that after 4-5 days I would start feeling better and stop the medication only to find out 48 hours later that the symptoms were coming back. I had a urine test which revealed no bacteria (although this was done after I had been taking the antbiotics) After several weeks of this my urologist though I may have IC and I underwent a cystoscopy and biopsy under general anaesthetic. The biopsy was normal and the cystoscopy didn't reveal anything abnormal with the bladder either. My urologist doesn't seem sure of what I have. I am now back on Ciproxin and have been on antibiotics for 11 weeks altogether (which concerns me a lot. Although the symptoms of frequency have improved I experience discomfort after emptying which to me feels as though this is in the area of the urethra and this lasts sometimes for 1/2 hour before easing. I still do not know what I have and what I am supposed to do after sexual intercourse to prevent infections and how to finally get rid of what I have now. I asked my Urologist if I had built up a resistance to antibiotics because of such a prolonged use of them but she didn't seem to think that was a problem, especially with Ciproxin...which surprised me. Do you have any suggestions as to how I get rid of this? Incidentally I have just 9 weeks ago started HRT (Premia5)?? I'm 49 years old.
Many thanks, Kate
Dear Kate.
First of all I cannot diagnose you over the internet. It sounds like your urologist has done an extremely thorough examination of you and your voiding difficulties. Interstitial cystitis is a diagnosis of exclusion and it sound as if your doctor has done the appropriate test to exclude other disease processes. I will include a list of symptoms, treatments and an address where you can get more information, but any further diagnosis will need to be done be your urologist.
I sympathize with your condition and plan to provide you with information such that you can understand that you are not alone. You may have a condition known as interstitial cystitis(IC). This is a chronic inflammation of the bladder wall. It differs from common cystitis in that the later is caused by a bacterial infection which can be treated by bacterial antibiotic therapy. It is also important to note that IC is not a psychosomatic disorder nor is it caused by stress.
IC can affect people of any age,race or sex. It is, however, most commonly found in women. A 1987 epidemiological study estimated that 450,000 people may be affected by the disease. The symptoms include:
-Frequency-Day and/or night urination(up to 60 times a day in severe cases.) In early or very mild cases,frequency is sometimes the only symptom.
-Urgency-The sensation of having to urinate immediately may also be accompanied by pain,pressure or spasms.
-Pain-Can be in the abdominal,urethral,or vaginal area. Pain is also frequently associated with sexual intercourse.
-Other Disorders-Sometimes patients also report experiencing symptoms such as muscle and joint pain,migraines,allergic reactions,colon and stomach problems as well as the more common symptoms of IC described above.
Diagnosis is very difficult and must follow several steps:
1)Urine cultures must be negative
2)Rule out other associated disease,bladder cancer, stone disease, anatomic abnormalities
3)cystoscopy-routine cystoscopy in the clinic may not be sufficient to make a diagnosis of IC. It is usually necessary to distend the bladder under general anesthesia in order to see pinpoint hemorrhages on the bladder wall a hallmark of this disease. It may even be necessary for a biopsy to be taken at that time as well.
4)Diagnostic radiology-IVP,KUB
Treatments
1)Bladder distention
2)Oral medication-anti-inflammatory drugs,antispasmotics,antihistamines and muscle relaxants.
3)DMSO(Dimethlyl Sulfoxide)-bladder instillation
4)Elmiron-(Sodium Pentosanpolysulfate)
5)Anti-depressants
6)Diet
7)Tens Unit
8)Silver Nitrate
9)Clorpactin WCS-90
10)Self Help- biofeedback
11)Surgery
. For more information you could contact the Interstitial Cystitis Association,P.O. Box 1553,Madison Square Station,New York,NY 10159. (212) 979-6057.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword:Interstitial Cystitis
In Reply to: Do I have IC? posted by Kate on August 27, 1998 at 05:10:16:
I have had an 8 year history of bladder problems. It started with cystitis after sexual intercourse years ago. I was put on antibiotics to take at "risk" times and kept this up for years. About 4 years ago I came down with a bladder inflammation which was confirmed by a cystoscopy. This took about 3 months to heal. I found that as time went by the antibiotics grew stronger and I had to take them longer to keep infection away. About 11 weeks ago while taking Ciproxin I felt I was getting cystitis (frequent urinating and no relief afterwards) I also felt as though I was going to "wet" myself. After a visit to my Urologist my antibiotics were changed from Ciproxin to Nitrofurantoin and the problem immediately became worse. I changed medictaion to Noroxin. It seemed that after 4-5 days I would start feeling better and stop the medication only to find out 48 hours later that the symptoms were coming back. I had a urine test which revealed no bacteria (although this was done after I had been taking the antbiotics) After several weeks of this my urologist though I may have IC and I underwent a cystoscopy and biopsy under general anaesthetic. The biopsy was normal and the cystoscopy didn't reveal anything abnormal with the bladder either. My urologist doesn't seem sure of what I have. I am now back on Ciproxin and have been on antibiotics for 11 weeks altogether (which concerns me a lot. Although the symptoms of frequency have improved I experience discomfort after emptying which to me feels as though this is in the area of the urethra and this lasts sometimes for 1/2 hour before easing. I still do not know what I have and what I am supposed to do after sexual intercourse to prevent infections and how to finally get rid of what I have now. I asked my Urologist if I had built up a resistance to antibiotics because of such a prolonged use of them but she didn't seem to think that was a problem, especially with Ciproxin...which surprised me. Do you have any suggestions as to how I get rid of this? Incidentally I have just 9 weeks ago started HRT (Premia5)?? I'm 49 years old.
Many thanks, Kate
Dear Kate.
First of all I cannot diagnose you over the internet. It sounds like your urologist has done an extremely thorough examination of you and your voiding difficulties. Interstitial cystitis is a diagnosis of exclusion and it sound as if your doctor has done the appropriate test to exclude other disease processes. I will include a list of symptoms, treatments and an address where you can get more information, but any further diagnosis will need to be done be your urologist.
I sympathize with your condition and plan to provide you with information such that you can understand that you are not alone. You may have a condition known as interstitial cystitis(IC). This is a chronic inflammation of the bladder wall. It differs from common cystitis in that the later is caused by a bacterial infection which can be treated by bacterial antibiotic therapy. It is also important to note that IC is not a psychosomatic disorder nor is it caused by stress.
IC can affect people of any age,race or sex. It is, however, most commonly found in women. A 1987 epidemiological study estimated that 450,000 people may be affected by the disease. The symptoms include:
-Frequency-Day and/or night urination(up to 60 times a day in severe cases.) In early or very mild cases,frequency is sometimes the only symptom.
-Urgency-The sensation of having to urinate immediately may also be accompanied by pain,pressure or spasms.
-Pain-Can be in the abdominal,urethral,or vaginal area. Pain is also frequently associated with sexual intercourse.
-Other Disorders-Sometimes patients also report experiencing symptoms such as muscle and joint pain,migraines,allergic reactions,colon and stomach problems as well as the more common symptoms of IC described above.
Diagnosis is very difficult and must follow several steps:
1)Urine cultures must be negative
2)Rule out other associated disease,bladder cancer, stone disease, anatomic abnormalities
3)cystoscopy-routine cystoscopy in the clinic may not be sufficient to make a diagnosis of IC. It is usually necessary to distend the bladder under general anesthesia in order to see pinpoint hemorrhages on the bladder wall a hallmark of this disease. It may even be necessary for a biopsy to be taken at that time as well.
4)Diagnostic radiology-IVP,KUB
Treatments
1)Bladder distention
2)Oral medication-anti-inflammatory drugs,antispasmotics,antihistamines and muscle relaxants.
3)DMSO(Dimethlyl Sulfoxide)-bladder instillation
4)Elmiron-(Sodium Pentosanpolysulfate)
5)Anti-depressants
6)Diet
7)Tens Unit
8)Silver Nitrate
9)Clorpactin WCS-90
10)Self Help- biofeedback
11)Surgery
. For more information you could contact the Interstitial Cystitis Association,P.O. Box 1553,Madison Square Station,New York,NY 10159. (212) 979-6057.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword:Interstitial Cystitis
