Interstitial cystitis, or painful bladder syndrome, is a frequently under-diagnosed problem leading to urgency, frequency, and pelvic pain, in the absence of urinary tract infection or other bladder pathology. Women with this condition often void multiple times a day in order to avoid bladder discomfort. While the disease is characterized by a relapsing/remitting course, over time chronic pain becomes the most prominent symptom. Pain in localized to the bladder area, as well as urethra, vagina, lower abdomen, and vulva.
Interstitial cystitis is associated with impairment in quality of life and sexual functioning. Symptoms often get worse following sexual activity due to pressure on the sensitive tissues of the anterior vagina, lower abdomen and urethra. Patients with interstitial cystitis may have concomitant high tone in their pelvic floor musculature, which also contributes to painful intercourse. These women frequently describe avoidance of sexual activity, pain, low desire and problems achieving orgasm.
Appropriate management of interstitial cystitis often involves a multidisciplinary team approach and more than one treatment regimen. However, targeting the bladder pathology via dietary modification, oral medications, or bladder instillations as well as addressing pelvic muscle spasm with pelvic floor physical therapy may greatly improve patients’ symptoms and sexual function.