Jun 08 2008
Getting an IC diagnosis
Interstitial cystitis (IC) is a chronic and debilitating disease of the urinary tract and bladder that affects approximately one million people. There is an inflamed and irritated bladder wall that leads to many bladder symptoms. The bladder wall of an IC patient will have stiffening and scarring of the bladder, less bladder capacity as a result of the scarring, small pinpoint bleeding on the bladder (glomerulations) and ulcers in the bladder lining (Hunner’s ulcers).
So much isn’t known about the illness, even though it has been around for a while now. This article deals with the signs and the symptoms of interstitial cystitis. A general guideline for interstitial cystitis is from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), and although it has come under fire and scrutiny as it doesn’t incorporate all of the prevailing symptoms and has some things included as an exclusion that some people with IC do indeed have, it is meant as a oversee of the illness and not a conclusive.
NIDDK Research Definition of Interstitial Cystitis
Inclusion Criteria
1. Cystoscopy - glomerulations and/or classic Hunner’s ulcer.
2. Symptoms - bladder pain and/or bladder urgency.
Exclusion Criteria
1. Bladder capacity greater than 350cc on awake cystometry.
2. Absence of an intense urge to void with the bladder filled to 100cc during cystometry using a fill rate of 30-100cc/min.
3. Demonstration of phasic involuntary bladder contractions on cystometry using the fill rate described in number 2.
4. Duration of symptoms less than 9 months.
5. Absence of nocturia.
6. Symptoms relieved by antimicrobials, urinary antiseptics, anticholinergics, or antispasmodics.
7. Frequency of urination while awake of less than eight times a day.
8. Diagnosis of bacterial cystitis or prostatitis within a 3-month period.
9. Bladder or ureteral calculi.
10. Active genital herpes.
11. Uterine, cervical, or urethral cancer.
12. Urethral diverticulum.
13. Cyclophosphamide or any type of chemical cystitis.
14. Tuberculous cystitis.
15. Radiation cystitis.
16. Benign or malignant bladder tumors.
17. Vaginitis.
18. Age less than 18 years.
This is a research definition only (for inclusion of patients in clinical trials) and is not necessarily applicable to diagnoses made in clinical practice. The major difference in the less stringent Interstitial Cystitis Database (ICDB) inclusion criteria for the diagnosis of IC is that cystoscopy (and its related diagnostic criteria) is an optional criterion for entry into the ICDB study. The rigid urodynamic exclusion criteria in the NIDDK definition do not exclude patients from an ICDB IC diagnosis.
