genitourinary disorders
Interstitial Cystitis
Introduction
Interstitial cystitis is noninfectious bladder inflammation that causes pain (suprapubic, pelvic, and abdominal), urinary frequency, and urgency with incontinence. Diagnosis is by history and exclusion of other disorders clinically and by cystoscopy and biopsy. With treatment, most patients improve, but cure is rare. Treatment varies but includes dietary changes, bladder training,pentosan, analgesics, and intravesical therapies. (See also Overview of Voiding .) Incidence of interstitial cystitis is unknown, but the disorder appears to be more common than once thought and may underlie other clinical syndromes (eg, chronic pelvic pain). White people are more susceptible, and 90% of cases occur in women. Cause is unknown, but pathophysiology may involve loss of protective urothelial mucin, with penetration of urinary potassium and other substances into the bladder wall, activation of sensory nerves, and smooth muscle damage. Mast cells may mediate the process, but their role is unclear. 