Interstitial cystitis is a chronic, painful inflammatory lesion of the bladder wall, which is unknown. Unlike common cystitis, interstitial cystitis is not caused by bacteria and is not effective with conventional antibiotics**. It's also important that it's not caused by a physical or mental disorder or stress. The impact of interstitial cystitis on an individual's life should not be underestimated, as it can be debilitating and lead to feelings of helplessness and hopelessness. Patients often have to go through a lengthy process of medical care before they can be definitively diagnosed.
Urinary frequency, urgency, and pain with a full bladder are the most common symptoms of IC BPS, and not all patients have bladder or pelvic pain, although urinary urgency and suprapubic discomfort are present, and about 1 to 3 patients have no pain.
For patients with the above symptoms, the voiding diary shows more than ten or even dozens of urinations per day, accompanied by pain during the urinary storage period, and the maximum single urine volume is less than 300ml, the possibility of IC BPS needs to be considered. Urodynamic studies, cystoscopy and bladder water dilation, biopsy, and pathology have a place in the diagnosis.
Although urodynamic studies appear to be able to identify increased bladder sensitivity and decreased bladder capacity, these findings are not characteristic markers of IC. Although urodynamic testing is not required for the diagnosis of IC, it is important in the presence of:1Excludes bladder outlet obstruction and detrusor overactivity;2.Confirm the clinical symptoms of IC;3.Objective basis for obtaining a hypersensitive bladder;4.Assess bladder compliance;5.Assess the severity of bladder pathology;6.Efficacy was objectively evaluated after **.
Cystoscopy that is considered to be positive for IC BPS is grade 2 to 3 bulbous hemorrhage or Hunner lesions, or both.
Hunner ulcers are not chronic ulcers, but are characteristic deep rupture of the mucosa and submucosa caused by bladder distension. Hunner lesions typically appear as an eversion of the red mucosal area, where small blood vessels radiate to the scar and fibrin deposits or coagulations attach to the area. Under cystoscopy, the bladder mucosa in typical IC shows red regional changes, and as the bladder expands, the small blood vessels in the center of the region rupture, and the surrounding small blood vessels radiate around them, forming the above typical changes.
Nonulcerative IC has a normal mucosal morphology on initial cystoscopy. Submucosal globular hemorrhage after bladder water dilatation is a positive marker for diagnostic IC. However, there is no consistent relationship between bladder bulb bleeding and the diagnosis of IC BPS. The grade of intravesical bulbular bleeding varies over time, but symptom severity does not correlate with the number of intravesical bleeding spots. Intravesical bulbular bleeding has also been found in healthy, asymptomatic people and symptomatic people with other major diagnoses. There is no global consensus on the importance of intravesical bulbular hemorrhage in the diagnosis and prognosis of IC BPS.
Bladder water dilation can provide temporary symptom relief, but it does not provide a bps. It is unclear whether repeated electrocautery excision or bladder dilation exacerbates bladder wall fibrosis caused by the disease, so the potential risk of this type of bladder** cannot be determined. Bladder hydrodilation is not a risk-free procedure, with bladder rupture occurring in about 8% of patients, and bladder necrosis after hydrodilation has been reported. These are serious complications that require major surgical repair.
Differential diagnosis of IC BPS: Bladder cancer and carcinoma in situ, infection, radiation, chemotherapy (including cyclophosphamide immunization**) bladder neck obstruction and neurogenic bladder, bladder stones, lower ureteral calculus, urethral diverticulum, urinary prolapse, endometriosis, candidiasis, cervical, uterine and ovarian cancer, bladder emptying, overactive bladder, prostate cancer, benign prostatic hyperplasia, chronic bacterial prostatitis, chronic non-bacterial prostatitis,** Nerve compression, pelvic muscle-related pain, etc.