Course Description:

IC, also called painful bladder syndrome, is a chronic condition characterized by bladder pain and lower abdominal and pelvic discomfort related to bladder filling. The most common symptoms include frequency, urgency, and nocturia. The cause is unknown. Emotional or physical stress may exacerbate symptoms. The condition is usually diagnosed by ruling out other conditions, including sexually transmitted diseases (STDs), bladder cancer, and bladder infections; however, IC is frequently misdiagnosed, and patients often go years without a correct diagnosis. Women are 10 times more likely than men to have IC, and IC is most common in the 4th and 5th decades of life. There is no cure and no consensus on optimal management. First-line treatment focuses on patient education, behavioral modification, and stress management. Physical therapy treatment reported to be beneficial includes manual therapy techniques to resolve pelvic, abdominal, and/or hip muscular trigger points; lengthen muscle contractures; and release connective tissue restrictions. Up to 50% of patients experience spontaneous remission. Prescribed medications, which can be administered orally or intravesically, include amitriptyline, antihistamines, antibiotics, opioid analgesics, cyclosporine, lidocaine, heparin, and dimethyl sulfoxide (DMSO). Surgical intervention is not typically recommended unless symptom management is unsuccessful with conservative interventions and the patient’s quality of life is significantly affected.