Glossary of Terminology


To help you better understand IC, below is a list of medical terms that may be used in relation to IC and related conditions.

This word list is not meant to be a substitute for professional medical care. The ICA recommends you consult your own physician regarding any course of treatment or medication. Any products or therapies described below should not be construed as recommended or endorsed by the ICA.

Please click the first letter of the word, or scroll to view.

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z


acetylcholine

A chemical, known as a neurotransmitter, prevalent in the central nervous system which plays an important role in the transmission of nerve impulses in the parasympathetic nervous system, which controls, among other things, the function of smooth muscles, including those of the bladder.
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acupressure

A type of massage developed in ancient China in which pressure is applied with the fingers to specific acupuncture points along "energy channels" in order to stimulate the production of certain body chemicals which have the potential to relieve pain, stimulate other desired effects, and relax muscles. Some IC patients have found acupuncture and acupressure beneficial, although some who initially experience improvement have reported that the effects are not long-lasting.
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acupuncture

The tradition of healing developed in ancient China in which needles are applied to designated points along energy channels to stimulate "chi," defined as "the life force," or "energy." "Needling" of specific points has the potential to relieve pain through the stimulation of specific chemicals called endorphins, and to relax muscles. Some IC patients receive relief or a decrease in symptoms and often report an improvement in well-being, while others do not experience any or much improvement. Although acupuncture has been widely practiced in the US, it was only recently approved by the FDA (Food and Drug Administration) for general use.
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acute

Used to describe the onset of symptoms, usually sudden, severe and intense. Acute pain is a warning from the body that something is wrong. The onset of IC symptoms is often acute, but symptoms may also develop slowly and gradually. See chronic.
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aerobic activity

Physical exertion which raises the heart rate to a specified range, or "target heart rate." In general, the "target heart rate" can be determined by taking 220, subtracting your age, and taking 80% of that figure. To derive maximum benefits, 20 to 30 minutes of aerobic activity five to six days a week should be the general goal. Three to four days a week is sufficient for maintenance. The benefits of aerobic exercise may include healthy weight loss, sounder sleep, a heightened sense of well being, lighter menstrual periods, improved circulation, possible lowering of cholesterol, and decreased risk of heart disease and osteoporosis, among many others. Any exercise that raises the heart rate to the "target" range will work, including swimming, water-walking, and low-impact aerobics. You should consult a physician before initiating a strenuous exercise program, and take a treadmill stress test if advisable to determine your safe target heart rate.
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afferent nerves

Nerves that transmit sensory impulses from the skin, muscles, or organs inward to the spinal cord and brain.
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allergen

A substance that can cause an allergic response in the body, but is only harmful to some people, whose immune systems may be hypersensitive. See antigen.
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Americans With Disabilities Act (ADA)

This act of Congress prohibits discrimination against people with disabilities in employment and in public services (except the US Government), public and private transportation, public accommodations and telecommunications services. As defined by this act, a disability is a physical or mental impairment that substantially limits one or more of a person's major life activities. This Act applies to businesses with 15 or more employees.
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amino acids

The building blocks of proteins in the body, as well as the products of protein breakdown. Twenty amino acids are necessary for normal metabolism and they are divided into two groups: non-essential amino acids that are produced by the body, and essential amino acids that must be obtained through the diet. L-arginine and l-tryptophan are examples of amino acids.
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analgesic

A prescription or over-the-counter medication which relieves pain, ranging from non-steroidal anti-inflammatory medications, known as NSAIDs (Motrin®, Anaprox®), aspirin (Anacin®, Bufferin®) and other pain relieving products such as acetaminophen (Tylenol®), to opioids (morphine, codeine).
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anesthesia

Medications that bring about loss of sensation, especially the awareness of pain. Types of anesthetics include general, local, regional and topical.
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antiarrhythmics
A class of medications generally used to treat heart arrhythmias, and currently being studied as a treatment for neuropathic pain.
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antibiotics

Medications used to treat bacterial or microbial infections. Also referred to as antimicrobials. Antibiotics are used to treat urinary tract infections (UTIs). However, they are not considered an effective treatment for interstitial cystitis. Side effects can include nausea, rash, fever, fatigue, and overgrowth of yeast.
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antibodies

Molecules produced by the immune system that attach themselves to foreign substances and incapacitate them. See immune response.
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anticholinergic

A class of medications which blocks the passage of nerve impulses through the parasympathetic nervous system. Anticholinergic effects may include relaxation of the bladder and decreased intensity of bladder contractions, as well as dryness of mucous membranes, i.e. dry mouth, constipation. Examples of anticholinergic medications include tricyclic antidepressants (Elavil®, Sinequan®) and antispasmodics (Cystospaz®, Ditropan®, Levsin®).
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anticonvulsants

A class of medications originally designed to treat epilepsy, anticonvulsants are now being used to treat other conditions, such as neuropathic pain.
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antihistamines

Prescription or over-the-counter medications that counter the activity of histamine, a substance normally present in the body that causes irritation and inflammation when released from injured cells. See mast cells.
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antigen

A substance, foreign to the body, usually a protein or carbohydrate, capable of producing an immune response. Antigens can cause allergic reactions in some people.
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antimicrobial medications

Types of medications which kill or prevent the growth of microorganisms such as viruses, bacteria and fungi. Examples of these types of medications include antibiotics, antifungals, and antiviral preparations.
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antispasmodic medications

Medications which decrease or eliminate muscle spasms. Examples of antispasmodics include Cystospaz® and Levsin®.
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asymptomatic

Having no observable symptoms.
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augmentation cystoplasty (and supratrigonal cystectomy)

In this surgical procedure, the top of the bladder is excised, leaving the base and the urethra, and a piece of bowel is attached and fashioned into a "new" bladder. Patients continue to void normally through the urethra. This procedure has largely been abandoned for treatment of IC, due to serious complications, i.e. it may not relieve the pain associated with IC; IC may appear on the bowel wall (the "new" bladder). It is also not recommended for IC patients who have intractable symptoms, yet have a good bladder capacity under anesthesia. See urinary diversion.
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autoimmune

A condition in which the immune system produces antibodies against the body's own tissues, sometimes damaging the tissues and causing disease.
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autonomic nervous system

The part of the nervous system that regulates involuntary bodily functions (functions not consciously controlled) such as heart rate, breathing and the G.I. (gastrointestinal) tract. The autonomic nervous system consists of two parts, the parasympathetic nervous system and the sympatethic nervous system.
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benign prostatic hyperplasia

Enlargement of the prostate gland.
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benzodiazepines

A group of medications used to treat anxiety and muscle spasms. These medications, including Xanax®, Valium® and Klonopin®, are sometimes prescribed for IC symptoms. Side effects include drowsiness and loss of coordination. A physician should monitor the use of these medications, as they may be habit-forming.
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bicarbonate

A naturally occurring salt that is a constituent in many chemical compounds. In the form bicarbonate of soda, or baking soda, it serves as an antacid. Sodium bicarbonate raises the pH of urine and may temporarily relieve IC symptoms. Should not be used by patients on a salt-restricted diet.
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biofeedback

A technique in which a person may learn how to exert conscious control over involuntary responses such as heart beat, blood pressure, skin temperature, breathing, etc. Responses may be monitored and progress can be recorded using electronic devices, computers, and video display terminals. Using biofeedback, some IC patients have learned to relax the pelvic floor muscles and hence, reduce painful muscle spasms.
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biopsy

A diagnostic test in which samples of tissue are obtained for examination under a microscope. In bladder biopsies, which are performed under general or regional anesthesia, tissue samples are taken of the bladder wall using a long forceps. A biopsy of the bladder wall may be necessary to rule out other diseases such as bladder cancer (which is not associated with IC) and to assist in the diagnosis of IC. A bladder biopsy may also be required for participation in research studies.
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bladder

The urinary bladder is a hollow sac that normally holds 12 to 16 ounces of urine at a time (its functional capacity), although it is capable of holding from 25 to 30 ounces (its true capacity). The bladder wall is composed of 1) a thin mucous membrane lining (mucin or the glycosaminoglycans or GAG layer); 2) an epithelial lining; 3) a layer of connective tissue; and 4) the outer muscular layer called the detrusor. Voiding is controlled by both voluntary and involuntary nerves and normally occurs every two to five hours.
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bladder cocktail

A solution of a combination of medications that is infused into the bladder by means of a catheter. The bladder cocktail usually refers to a combination of DMSO, steroids, Marcaine®, sodium bicarbonate and heparin. This procedure is typically done in a doctor's office.
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bladder holding protocol

See bladder retraining.
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bladder neck

The place where the urethra joins the body of the bladder.
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bladder retraining program

Also called "bladder holding protocol." A technique which can decrease urinary urgency and frequency by holding urine for progressively longer intervals. The pain of IC must first be addressed before bladder retraining can be used successfully. After determining the shortest comfort interval between voids, the patient ignores the first urge to void and waits a set amount of time before voiding, for example, three to five minutes. After several weeks, the bladder nerves may become acclimated to the longer voiding interval, and the interval is lengthened. Over several months the comfort interval between voids can be lengthened substantially and some patients are even able to establish a "normal" voiding pattern. Bladder retraining can be done with the help of a therapist who is familiar with this regime, or can be done on your own.
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bladder-sphincter dyssynergy

Lack of coordination between the urethral sphincter and bladder muscle which are under involuntary control.
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bradykinin

A slow-acting but powerful peptide that promotes blood flow by widening blood vessels. Bradykinins also constrict smooth muscles, and stimulate pain receptors.
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Candida albicans

A yeast normally found in the mucous membrane tissues of the mouth, G. I. tract, and vagina. An overgrowth in the vagina can cause itching, burning, and a whitish cottage cheese-like discharge which has the characteristic pungent odor of yeast. Normally, adequate levels of the lactobacillus acidophilus bacteria keep yeast growth under control. Too much yeast may also function as an allergen, and is thought to be a factor in a wide variety of illnesses, although this theory remains controversial in mainstream medicine.
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capsaicin

The active ingredient in many hot peppers. Capsaicin bonds to specific receptors and releases potent neurotransmitters which initially cause irritation and pain, desensitization of the nerve fibers, resulting in a period of pain relief. Capsaicin has been instilled into the bladders of some IC patients on an experimental basis. Preliminary studies have not found capsaicin to be effective in treating IC symptoms.
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catecholamine

One of the amines, or nitrogen-containing neurotransmitters in the body, including dopamine, epinephrine, and norepinephrine, which affects, among other things, the activity of smooth muscles, and may be increased by stress.
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catheter

A narrow rubber tube used to instill or drain fluids, including urine, from the body.
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central nervous system (CNS)

The brain and spinal cord
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cholinergic

Nerve endings which release the neurotransmitter acetylcholine.
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chronic

Chronic pain is lingering pain which serves no practical purpose. IC is considered to be a chronic condition, but may be acute in onset as well. Chronic pain persists over time.
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chronic fatigue and immune dysfunction syndrome (CFIDS)

A serious and complex illness that affects many different organ systems. It is characterized by incapacitating fatigue (experienced as profound exhaustion and extremely poor stamina), neurological problems and numerous other symptoms. CFIDS can be severely debilitating and can last for many years. CFIDS is often misdiagnosed and/or frequently unrecognized and can resemble other disorders including mononucleosis, multiple sclerosis (MS), fibromyalgia (FM), Lyme disease, post-polio syndrome and autoimmune diseases such as lupus. CFIDS is also known as chronic fatigue syndrome (CFS) and myalgic encephalomyelitis (ME).
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classic IC

See Hunner's patch.
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Clorpactin WCS-90® (sodium oxychlorosene)

Chemically related to household bleach, Clorpactin was an early intravesical treatment for IC and continues to be used on a limited basis, primarily for people who do not respond to DMSO or other therapies. Clorpactin exerts a detergent action on the bladder's lining, possibly destroying nerve endings. This treatment can be very painful and should be done under general anesthesia. It can, however, be diluted and instilled into the bladder as an in-office procedure. Initial symptom worsening is to be expected.
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collagen

The fibrous protein that forms, among other things, the connective tissue.
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congenital abnormality

A condition, disease, or functional problem which is present at birth and may resolve, or may continue for many years or for life.
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continence

The ability to hold urine until an appropriate time and place can be found to empty it.
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contraindication

A condition or factor that indicates that a particular treatment or medication is unsuitable for use.
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cortisol

A steroid hormone produced by the adrenal glands which helps regulate the metabolism of many bodily substances. A synthetic derivative of cortisol, hydrocortisone has very strong anti-inflammatory properties.
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cox - 2 inhibitor

A new type of anti-inflammatory medication that works by blocking the inflammatory enzyme cyclo-oxygenase (cox), but does not appear to block the Cox - 1 enzyme that protects the stomach lining. Cox - 2 inhibitors are similar to NSAIDs in pain relieving properties.
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culture and sensitivity test

A urine test that identifies the presence of bacteria in the urine and identifies the specific antibiotic(s) that can inhibit or prevent their growth. Results of this test are usually available in two to three days.
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cystectomy

Surgical removal of the entire bladder
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cystocele

A hernia or pouch from the bladder which protrudes through a weak spot in the vaginal wall. Urine may collect in the pouch providing a medium for bacteria to multiply, causing recurrent bladder infections.
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cystometry

One of the urodynamic tests. The bladder is filled with water and as the fluid is instilled and expelled, the pressure changes are recorded by an electronic monitor. This test measures bladder capacity and the bladder's ability to empty itself.
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cystoplasty

See augmentation cystoplasty.
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cystoscope

A thin narrow telescope-like instrument fitted with a light and camera which urologists use to see inside of the bladder. This instrument is used to perform a cystoscopy.
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cystourethrocel

A herniation or protrusion of part of the urethra into the vagina
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cytokines

Inflammatory mediators that play a part in immune response.
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dehydration

A condition resulting when not enough fluid is available to fulfill the body's fluid requirements; may be caused by excessive heat, sweating, urination, diarrhea or insufficient fluid intake. Severe or chronic dehydration is dangerous and can result in damage to the kidneys, bladder, or other organs.
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detrusor muscle

The bladder's muscular layer which contracts to expel urine.
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detrusor hyperreflexia

Hyperactivity or overactivity of the bladder muscle, caused by inappropriate nerve signals.
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diabetes mellitus

A condition in which the body does not produce enough insulin, the hormone which regulates the amount of sugar (glucose) in the bloodstream and cells. Symptoms include extreme thirst, excessive urination, and hunger.
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dopamine

One of the catecholamines which is active in the synthesis of norepinephrine, a hormone that participates in blood vessel constriction and smooth muscle function. Dopamine is synthesized in the brain from tyrosine, one of the essential amino acids that must be obtained through the diet.
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dysmenorrhea

Painful menstruation.
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dyspareunia

Painful sexual intercourse.
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dysuria

Painful urination, which may be acute or chronic, caused by infection, inflammation, or other conditions.
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efferent nerves

Nerves which transmit signals away from the central nervous system - compare to afferent nerves. Nerves that transmit signals from the brain and spinal cord to bodily organs, skin and muscles.
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electromyogram (EMG)

A record of the electric impulses in a muscle. One of the urodynamic tests in which the strength of the pelvic muscles is tested while the bladder fills and empties. EMG is helpful in determining the dysfunction of the pelvic floor musculature, and is being used in pelvic floor biofeedback strategies.
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endometriosis

The presence and growth of functioning endometrial tissue (mucous membrane lining the uterus) in places other than the uterus. Often, endometriosis results in pain and infertility. Endometriosis can co-exist with IC.
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endorphin

A chemical produced in the brain that is similar to opioid medications, and can reduce pain. This naturally occurring chemical is increased through aerobic activity. Endorphins are considered the body's natural pain reliever.
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endoscopic procedure

Any procedure in which a tube-like instrument, such as a cystoscope, is inserted into a natural opening or incision to view the inside of an organ or cavity.
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enuresis

Involuntary urination. Nocturnal (nighttime) enuresis generally refers to bedwetting.
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epidemiology

The study of the causes, prevalence, frequency, and distribution of diseases in the general population or within a certain population. An epidemiologist is a person who studies the interrelationships between these factors.
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epinephrine

A hormone produced by the adrenal glands and other tissues which causes the blood vessels to contract. Synthetic epinephrine is also available.
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epithelial cells

The topmost or superficial layer of cells of the skin, or the mucous membrane linings of body cavities. See urothelial cells.
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estrogen

The primary female sex hormone, which promotes the development of the genitalia and breasts, stimulates ovulation, and promotes the growth of the uterine lining during the last two weeks of the menstrual cycle.
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etiology

(the study of) The cause or causes of diseases.
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fascia

Fibrous connective tissue forming a thin membrane which covers and binds muscles together.
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feline urethral syndrome

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fibromyalgia syndrome (FMS)

Pain in the muscles, ligaments and tendons-the fibrous tissues in the body. FMS is also known as fibrositis, implying that there is inflammation in the muscles, but research has proven that inflammation does not exist. To meet established diagnostic criteria, a patient must have widespread pain in all four quadrants of the body and at 11 of 18 specified tender points for more than three months. Symptoms may include pain, fatigue, disturbed sleep, headaches, cognitive dysfunction, IC-like bladder symptoms, as well as other symptoms.
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fibrosis

The abnormal growth or thickening of fibrous tissue; scar tissue.
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fulguration

The heating of tissue by a high-frequency electrical current applied with a needle shaped electrode.
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general anesthesia

The total lack of sensation and consciousness brought on by the use of anesthetic medications. These anesthetics are usually delivered in the operating room by injection into the vein or by breathing- in anesthetic gases. See anesthesia.
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generic

Regarding medications, refers to formulations not protected by trademark. Generic formulations contain the same basic ingredients approved by the FDA, but may contain varying amounts of additives, filler, color, et cetera. When available, generic medications are generally less expensive than their trademarked counterparts.
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glomerulations

Pinpoint hemorrhages found on the bladder wall of 90% of IC patients, which have become the hallmark of the non-ulcerative type of IC. Also known as petechial hemorrhages.
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glycosaminoglycan (GAG)

The mucous membrane coating of the bladder wall, composed of complex sugar molecules (mucopolysaccharides), which, in the normal bladder, protect the deeper layers from bacteria and urinary toxins. Although the cause or causes of IC are not known, many researchers believe that IC is caused by a defect in this lining.
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hematuria

Abnormal presence of blood or red blood cells in the urine. This blood can sometimes be detected visually, or by using a dip-stick test, or it may require microscopic observation.
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heparin

A naturally occurring substance in the body that acts on cells to prevent clotting in the veins. The medication derived from heparin, heparin sodium, is a compound that has both anti-inflammatory and surface protectant properties. It is instilled into the bladder as a treatment for IC. Heparin sodium is thought to mimic the bladder's mucous lining, temporarily "repairing" the GAG lining. It can be used as a primary treatment method, or as a "maintenance medication" to supplement other types of treatment.
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histamine

A normally occurring bodily substance which causes irritation and/or inflammation when released from mast cells. One of the substances involved in allergic responses. See antihistamines.
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holistic (also spelled wholistic)

A theory and tradition of healing that promotes treatment of the whole person.
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hormone

A substance produced by the endocrine glands, specifically the thyroid, adrenals, pituitary, and pancreas, as well as the ovaries and testes, which produces effects on many organs and tissues. Among their many functions, hormones help regulate metabolism, mediate behavior and responses to stress, facilitate resistance to disease, and promote growth and development, especially of the reproductive organs.
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hypothyroidism

Decreased activity of the thyroid gland. Symptoms may include weight gain, sluggishness, dry skin, intolerance to cold, and slowing of bodily processes. Treatment includes prescribing oral dosages of the deficient hormone. Dosage is adjusted to stabilize thyroid hormone levels.
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Hunner's patch

Originally described by Dr. Guy Hunner, an American urologist, in 1915 and characterized as "ulcers" on the bladder wall, these distinctive reddened patches typically have central ridges or scarring and may ooze blood. About five to ten percent of IC patients have Hunner's patches which denote the "classic" form of the disease. Also called Hunner's ulcers.
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hysterectomy

Removal of the uterus, as well as the fallopian tubes, and ovaries. In subtotal hysterectomy, the cervix, the tip of the uterus that extends into the vagina, is preserved. In total hysterectomy the entire uterus is removed. Removal of one or both fallopian tubes is called salpingectomy. Removal of one or more ovaries is called ovariectomy or oophorectomy.
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hydrodistention

A procedure used in the diagnosis and treatment of IC. Throughout the procedure, a cystoscope is used to observe the walls of the bladder. The bladder is filled with 60 to 80 centimeters of water for eight minutes while the patient is under general anesthesia. The water is then drained from the bladder. Typically, a bloody effluent (the fluid that flows out of the bladder) is seen. Next, the bladder is examined while an irrigant (water) expands the bladder. Glomerulations (petechial hemorrhages) are seen in the bladders of 90 percent of patients with IC. In ten percent of patients with symptoms of IC no glomerulations are seen. Although symptoms may increase for a few days after cystoscopy/hydrodistention, some IC patients experience up to three months or more of symptom relief.
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idiopathic

Relating to symptoms or disease, of unknown cause
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ileal conduit loop

A surgical procedure in which urine is diverted from the bladder through a tube (conduit) constructed from a bowel segment. A stoma or opening is constructed on the outside of the abdomen and urine drains into a plastic bag (similar to a colostomy bag) attached to the abdomen.
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immune response

The body's defensive response against invasion by foreign substances, or substances that are interpreted as being foreign. The immune response system protects and defends the body from disease microorganisms and other foreign substances. The main tissues of the immune response system include the bone marrow, the thymus, and the lymphoid tissues.
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immunosuppressant medications

Medications used to suppress normal or hyperactive immune response; often used to treat autoimmune diseases. An example of an immunosuppressant medication is prednisone.
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incontinence

The inability to control urination. Two types of incontinence include: stress incontinence and urge incontinence. Stress incontinence occurs more often in women than in men, and is precipitated by coughing, sneezing, straining or heavy lifting. Urge incontinence describes the intense urge to urinate which may result in the loss of bladder control.
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inflammation

Derived from the Latin word meaning "to flame within," inflammation is the natural response to damage or injury to tissue. The inflammatory process involves dilation of blood vessels, increased blood flow, heat, redness, and swelling resulting in irritation or pain.
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interferon

A protein that stimulates immune response and helps regulate the manufacture of antibodies.
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interstitial cystitis (IC)

A chronic inflammatory condition of the bladder wall of unknown cause or causes. As yet, there is no specific sign, or marker for the disease, so it is made by excluding other diseases with similar symptoms. Symptoms of IC include urinary urgency and frequency, difficulty in urinating, small urine output, pain in the bladder and/or urethra that is temporarily relieved by voiding. In some patients, pain may radiate to the genitals, rectal area, and thighs. Urine cultures are negative. Cystoscopic examination of the bladder and hydrodistention under general anesthesia reveal petechial hemorrhages or glomerulations on the bladder wall in 90% of patients, and 10% exhibit Hunner's patches or ulcers.
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intravenous pyelogram (IVP)

An X-ray of the kidneys and ureters used to rule out abnormalities such as kidney stones, tumors and other bladder abnormalities.
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intravesical instillation

Filling the bladder with a liquid substance by means of a catheter. Many IC patients use this procedure at home on a regular or occasional basis employing self-catheterization.
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intravesical pressure

Pressure inside of the bladder which is the sum of the pressure exerted by the contents, plus pressure from outside sources such as tightening the pelvic floor muscles or pressure from a sudden movement such as coughing, laughing, or lifting.
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irritable bowel syndrome (IBS)

A common disorder of the intestines that leads to cramping, bloating, and changes in bowel habits. Some people with IBS have constipation (difficult or infrequent bowel movements); others have diarrhea (frequent loose stools, often with an urgent need to move the bowels); and some people experience both. Sometimes the person with IBS has a cramping, painful urge to move the bowels but cannot do so.
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ischemia

Decreased blood supply to an organ or body part.
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Kegel exercises

See pelvic floor muscles.
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lactobacillus acidophilus

A type of bacterium that normally inhabits the mouth, intestines, and vagina and helps maintain the normal environment of their tissues.
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lamina propria

A layer of connective tissue which separates the lining of the bladder from the bladder muscle.
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l-arginine

An amino acid that is available over-the-counter and has been studied as a possible treatment for interstitial cystitis. Researchers are Yale University found that nitric oxide synthase (NOS) - the enzyme that produces nitric oxide - was found to be lower in interstitial cystitis patients than in controls and much lower in interstitial cystitis patients than in patients with urinary tract infections. However, conflicting data from researchers in Stockholm, Sweden reported that above average levels of l-arginine are typically found in some inflammatory disorders, including IC. The Swedish research team found increased levels of nitric oxide in IC patients' bladders both before and after treatment with l-arginine. Recommended dose of L-arginine by researchers at Yale is 500mg three times daily for at least six months. The effect of this nitric oxide pathway should be to relax smooth muscle and decrease pain. There are also thought to be some possible immunologic effects as well. However, further studies have not supported its effectiveness.
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laser surgery

LASER is the acronym for lightwave amplification by stimulated emission of radiation, a single wavelength of radiation delivered by a "gun" or focusing tube which has the ability to destroy tissue. The neodymium-YAG "non-contact" laser is used in the treatment of bladder cancer and IC patients with Hunner's ulcers by heating and thus destroying the protein of cells in a focal point on the bladder wall.
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local anesthetic

Medication used to deaden pain. It can be injected under the skin, into the epidural space, or instilled intravesically (into the bladder). Examples of local anesthetics include Marcaine® and Lidocaine®. Other categories of anesthetics include topical, general and regional anesthesia.
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lumbar sympathetic block

Injections of local anesthetic into the epidural space (area outside the spinal cord) in the lower (lumbar) spine, resulting in the blocking of pain in this region.
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lupus

See Systemic Lupus Erythematosus.
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marker

A specific sign that disease is present. While a marker for IC has yet to be identified, a number of researchers are working to find a specific marker or markers for IC.
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mast cells

Cells found throughout the body which contain histamine, tryptase, and other chemicals typically involved in allergic reactions. When mast cells release their contents, the process is called "degranulation." These chemicals are released into surrounding tissues, causing irritation and/or inflammation.
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mastocytosis

An increased number of mast cells. This increase can be organ-specific, or can represent a disease known as mastocytosis, where mast cell proliferation is found throughout the body.
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meatus

A Latin word meaning "opening." In urology, meatus refers to the urethral opening located above the vagina in women and in the tip of the penis in men.
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micturition

The process of urinating.
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migraine headaches

Severe headaches often accompanied by visual disturbances, dizziness, nausea, and vomiting.
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mitral valve prolapse (MVP)

Abnormality of one or more of the small flaps of the mitral valve back into the upper chamber of the heart. This results in the improper closing of the mitral valve. Patients with mitral valve prolapse may have no symptoms, or may have chest pain, irregular heart rate, weakness, or breathing difficulty.
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mucin

See glucosaminoglycan.
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mucopolysaccharide

A complex carbohydrate molecule found throughout the body, including the bladder lining. The GAG lining of the bladder is thought to consist of mucopolysaccharide-like substances. Medications such as Elmiron®, Heparin and chondroitin are considered mucopolysaccharides.
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myalgia

Muscle pain.
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myofascial pain syndrome (MPS)

A neuromuscular condition that often co-exists with fibromyalgia. Myofascia is the thin, translucent film that wraps around muscle tissue, and holds all of the parts together.
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myofascial release

A type of massage focused on trigger points which develop in muscles due to chronic pain or overuse. Some IC patients have benefited from this type of treatment provided by physical therapists who are specially trained in this technique.
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narcotic

A pain medication which suppresses activity of the central nervous system (also called CNS depressant, or opioid analgesic) reducing or relieving pain. These medications can cause drowsiness, dry mouth, depressed appetite, nausea, constipation and respiratory depression. Reserved for severe forms of pain. Can result in physical dependence.
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National Institutes of Health (NIH)

The federal government agency that studies and funds research on diseases. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) is the section of the NIH that funds bladder research including IC.
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neurology

The study of nerves and the nervous system.
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neuropeptides

Substances composed of amino acids which have potent effects on muscles and pain mechanisms.
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neurotransmitter

A chemical that facilitates the transmission of nerve impulses.
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nocturia

Nighttime urination. Routinely waking more than two times at night to urinate is considered one of the signs of IC.
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non-steroidal anti-inflammatory drug (NSAID)

A class of medications, similar in structure to aspirin, and used to treat inflammation and pain. Examples of NSAIDs include ibuprofen (Advil®, Motrin®) and ketoprofen (Orudis®).
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norepinephrine

A neurotransmitter which, among its other functions, causes blood vessels to constrict.
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opioids

Medications made from, artificially developed from, or containing opium, a potent pain-killing substance that is derived from poppy pods. Examples of opioid medications include morphine, codeine and hydrocodone. Used to treat severe IC pain. Can result in physical dependence.
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pain

An unpleasant sense caused by signals from sensory nerve endings. Pain can generally be broken into three categories: neuropathic, somatic, and visceral. Each of these types of pain can be experienced concurrently and can be acute or chronic. Somatic pain relates to pain experienced in the body framework (skin, muscle, bone). Visceral pain is pain experienced in the organs of the body. Neuropathic pain, not typically recognized as a commonly occurring type of pain, may be a prominent feature in IC pain. Neuropathic pain implies the disruption of nerves or hypersensitization of nerves for various reasons. Neuropathic pain responds best to tricyclic antidepressants, anticonvulsants and antiarrhythmics. IC patients can experience all three types of pain.
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parasympathetic nervous system

The part of the autonomic nervous system in which nerves control the contractions of the involuntary smooth muscles, for example, the gastrointestinal (G.I.) tract, bladder and heart. The parasympathetic nervous system slows the heart rate, increases intestinal and gland activity, and relaxes the ring-like muscles or sphincters that open and close various passages in to body.
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paroxysmal supraventricular tachycardia (PSVT)

A common type of heart arrhythmia. Sudden bursts of very fast, or racing, heart rhythm. PSVT is more common in women than men. Symptoms include faintness, dizziness, anxiety and chest discomfort. PSVT is diagnosed with a loop recorder, which is worn 24 hours a day. The patient presses a button on the recorder to record a "racing heart" episode, and then transmits the recorded signal via telephone to the cardiologist for diagnosis. The cause of PSVT is not unknown. However, treatments are available.
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pathogen

An infectious agent such as bacteria or a virus which causes infection or disease.
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pelvic floor dysfunction (PFD)

A syndrome which can exist concurrently with IC. Pelvic floor dysfunction is characterized by inappropriate muscle activity in the complex of muscles that make up the pelvic floor. PFD is often accompanied by painful intercourse, difficulty in urination, irritable bowel syndrome (IBS) and chronic constipation.
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pelvic floor muscles

The muscles that support the pelvic organs including the bladder and uterus. These are the same muscles that, when contracted, stop the flow of urine. They can be strengthened by contractions (Kegel exercises). Over time, the number of contractions can be increased until several "sets" of twenty or thirty can be done comfortably.
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peptide

A molecular chain of two or more amino acids, which are components of protein synthesis.
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perineometer

A device invented by Dr. Arnold Kegel to measure the strength of the pelvic floor muscles.
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perineum

The short bridge of tissue between the vaginal opening and anus in women and between the scrotum (base of the penis) and anus in men. Some IC patients experience pain in this area.
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petechial hemorrhages

Tiny broken blood vessels, or hemorrhages, on the skin or mucous membranes, including the surface of the bladder. The IC Database revealed that 90% of IC patients have such hemorrhages, and these hemorrhages are considered to be a hallmark of IC.
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pH

This acronym stands for "potential for Hydrogen," a notation in chemistry which indicates how acidic or alkaline a substance is. The scale runs from 0 to 14, with 0 being very acidic, 7 being neutral (neither acid or alkaline) and 14 being very alkaline. Each number away from neutral indicates a value ten times more acidic or alkaline; for example, a pH of 8 is ten times more alkaline than the neutral pH of 7. In the case of IC, alkaline urine is considered to be less irritating to the bladder and some patients take Tums® or bicarbonate of soda to increase the alkalinity of their urine.
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physiology

A branch of biology that deals with the functions and activities of various organ systems, e.g. the circulatory system, urinary tract system, gastrointestinal system.
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placebo

A pill or treatment that has no medical effect. Placebos are used in controlled scientific studies to determine how effective a certain medication or treatment is as compared to no treatment.
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plasma

The colorless liquid component of blood that transports blood cells, nutrients and wastes to and from tissues. Also responsible for the maintenance of the body's acid/base balance.
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polyp

A small tumorlike growth that comes out from the surface of a mucous membrane. Polyps sometimes grow inside of the bladder around the bladder neck.
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potassium

An element which helps regulate the amount of fluid within the cells, intracellular pressure, and the acid-base balance. Also plays a role in nerve conduction and in normal muscle function.
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premenstrual syndrome (PMS)

A cluster of symptoms experienced by some women for several days prior to the start of menstruation. Symptoms may include irritability, nervousness, weight gain, fluid retention, headache, changes in mood and breast swelling and soreness. The cause of PMS is not fully understood.
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progesterone

A hormone manufactured in the ovaries and adrenal glands, which promotes the growth of the uterine lining during the last half of the menstrual cycle, referred to as the "luteal phase." Synthetic progesterone is used in birth control pills and in hormone replacement therapy.
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prognosis

The prediction of the outcome of a condition or disease based on all known factors.
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progressive muscle relaxation

Voluntarily contracting and relaxing different muscle groups, usually beginning at the top of the head, and working down to the toes. This technique can release muscle tension, possibly contributing to a reduction in pain, especially in the pelvic floor muscles which may be chronically contracted in IC.
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prostaglandin

A hormonelike fatty acid responsible for many bodily functions including smooth muscle tone, hormone functions, and various autonomic and central nervous system functions.
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prostate

A gland found in men that surrounds the neck of the bladder and the urethra.
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prostatitis

An infection, inflammation, discomfort, or pain in the prostate gland. There are four basic prostatic conditions: acute bacterial prostatitis (ABP), chronic bacterial prostatitis (CBP), non-bacterial prostatitis (NBP), and prostatodynia. Precise diagnosis of these conditions can be difficult because the symptoms are similar.

  • Acute bacterial prostatitis A bacterial infection of the prostate gland. Symptoms of sudden onset include chills, fever, urinary urgency and frequency, and difficulty in urinating. Bacteria can be cultured from prostatic secretions and urine.
  • Chronic bacterial prostatitis Symptoms are similar to acute bacterial prostatitis, except that onset is gradual, may be fairly mild, and may wax and wane. Some men may be asymptomatic, that is, they may not have any symptoms at all, yet bacteria can be cultured from prostatic secretions and urine.
  • Non-bacterial or abacterial prostatitis In this condition, men may experience irritative voiding symptoms, and white blood cells in the urine, which is a sign of inflammation and may be seen in prostatic secretions, but no bacteria can be cultured. Some men who are diagnosed with this condition may actually have IC.
  • Prostatodynia Pain or discomfort in the prostate of unknown origin which may also be felt in the rectum, perineum, or bladder. Some men who are diagnosed with this condition may actually have IC.

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pseudoaddiction

Can occur in chronic pain patients seeking adequate relief from their pain. This phenomenon may happen when a patient is under-prescribed pain medication, is then helped temporarily by the medication, and thus begins to horde the medication, seek out refills, multiple prescribers, etc. This is relief-seeking behavior, not addictive behavior. In reality, opioid abuse is rare in pain patients.
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psychosomatic

Illnesses or conditions caused or greatly influenced by psychological or emotional factors. The concept of psychosomatic illness is highly controversial in medicine, although it is understood that certain disorders may have a strong emotional component. Emotional stress is known to exacerbate numerous conditions, including IC, however, emotional stress does not cause IC.
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psyllium powder

A bulk-forming powder made from the psyllium plant, also called fleawort, which has been used to maintain bowel regularity. Psyllium powder is the primary ingredient of Metamucil®. Metamucil®, however, is sweetened with Nutrasweet® (aspartame), which has been reported to irritate the bladders of some IC patients. Psyllium powder, without any additives, can be purchased at health food stores. This product may cause flatulence at first, but this typically resolves. To avoid flatulence, begin with a small amount and work up to the recommended dose.
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pubococcygeus muscle

Part of the levator ani muscle, one of the group of muscles that form the pelvic floor. The other part of the levator ani is the iliococcygeus.
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pyuria

White blood cells in the urine, which may cause urine to appear cloudy. Generally indicative of infection.
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Raynaud's syndrome (Also called Raynaud's phenomenon)

A painful condition in which the fingers, toes, ears and/or nose experience sporadic attacks of blood flow interruption due to exposure to cold. Numbness, tingling and burning sensations may also be present.
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reflex sympathetic dystrophy (RSD)

A dysfunction involving the sympathetic nervous system. RSD most commonly occurs in the extremities and may cause severe pain.
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reflux

An abnormal backward motion of a substance in the body. Vesicoureteral reflux refers to the backward flow of urine from the bladder into the ureters.
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regional anesthesia

Numbing medication used to block a group of sensory nerve fibers. Examples of regional anesthesia include spinal and epidural injections. Results in numbness applied to a specific area or region of the body.
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retention (urinary)

The inability to void, which causes a buildup of urine in the bladder. IC patients can experience partial retention, in which all urine is not completely emptied from the urine during voiding, necessitating frequent voiding attempts at close intervals. Complete retention, or the inability to void any urine, can also occur. Complete retention is a serious condition that requires immediate medical attention.
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rheumatoid arthritis

An autoimmune disease in which the body rejects its own tissues. Considered a connective tissue disease. Occurs most commonly in women. Diagnosed by x-rays and blood tests. Symptoms include morning stiffness, joint pain and swelling, and nodes under the skin. Rheumatoid factor (RF) is found in the blood and synovial fluid of most rheumatoid arthritis patients. Treatments include rest, exercise to help maintain joint function, and medications to relieve pain and prevent swelling.
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sacral nerve stimulation

A permanent electrode implanted near the junction of the spinal cord and nerves, that provides electrical impulses that suppress the excitability or overactivity of sensory nerves which carry pain signals. A device of this type has been approved by the FDA for the treatment of urinary urge incontinence, frequency and urgency and has been used in the treatment of IC on an experimental basis.
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selective serotonin reuptake inhibitors (SSRIs)

A group of medications used to treat depression that stops or interferes with the dispersal or "reuptake" of serotonin at nerve junctions, allowing its effect to last longer. In IC, these medications are used for their anti-pain properties. Medications in this category include Prozac® (fluoxetine), Zoloft® (sertraline), and Paxil® (paroxetine). Although tricyclic antidepressants are considered to be more effective than SSRIs in treating IC, some IC patients have reported symptom relief using SSRIs.
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self-catheterization

Draining the bladder on a regular or occasional basis using a catheter. Some IC patients learn to catheterize themselves at home in order to instill certain medications, including local anesthetics, into the bladder.
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serotonin

A neurotransmitter, produced in the brain, and found in mucous membranes, which causes blood vessels to constrict. Serotonin, a precursor of tryptophan, also plays a prominent role in sleep and sensory perception.
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sign

Observable physical evidence of disease. In IC, glomerulations are a sign of the disease.
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Sjogren's syndrome

An autoimmune disorder that attacks the body's collagen and secretory glands, especially the tear ducts and salivary glands in the mouth.
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stoma

An opening. In urology, stoma generally refers to the outlet on the abdominal wall used for the collection of urine, after a urologic procedure such as an ileal conduit loop.
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stress incontinence

see incontinence
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substance P

One of the neuropeptides found in the body, and thought to play an active role in pain production in IC.
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suprapubic

The area on the lower abdomen, just above the pubic bone.
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suprapubic aspiration

A method of collecting urine using a syringe and needle which is inserted into the bladder at a point just above the pubic bone. Urine samples obtained by this method are considered the least likely to be contaminated by bacteria.
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suprapubic catheter

A very small catheter inserted into the bladder through the abdominal wall just above the pubic bone. This method of draining urine is sometimes employed temporarily if the urethra is very irritated, however, there is some increased risk of infection.
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sympathetic nervous system

Part of the autonomic nervous system that regulates involuntary bodily functions. The sympathetic nervous system speeds up heart rate, narrows blood vessels, and raises blood pressure.
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symptom

Any result of a disease process perceived by the patient. IC pain, for example, is a symptom.
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syndrome

A constellation of signs and symptoms which characterizes a disease or condition.
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systemic lupus erythematosus

A chronic autoimmune disease, commonly called lupus, causing inflammation of various parts of the body, especially the skin, joints, blood and kidneys. The body's immune system normally makes proteins called antibodies to protect the body against viruses, bacteria and other foreign materials. These foreign materials are called antigens. In an autoimmune disorder such as lupus, the immune system loses its ability to differentiate between foreign substances (antigens) and its own cells and tissues. The immune system then makes antibodies directed against "self." These antibodies, called "auto-antibodies," react with the "self" antigens to form immune complexes. The immune complexes build up in the tissues and can cause inflammation, injury, and pain. Lupus is considered a rheumatic disease.
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topical anesthesia

A type of numbing agent used on the surface of the skin or mucous membranes. Examples of local anesthetics include benzocaine and lidocaine.
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transcutaneous nerve stimulation (TENS)

A small battery-powered device, worn externally, that delivers a low level of electrical current to a particular part of the body through patch electrodes. The electrical current interferes with pain sensations. Long used to decrease chronic lower back pain, the TENS unit has also been found to help decrease bladder pain in some IC patients.
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transitional epithelium

The inner lining of the bladder just beneath the mucous membrane, or mucin, coating.
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transurethral

Referring to tests, treatments, or surgeries done through the urethra. Common surgeries include transurethral resection of the prostate (TURP) for benign prostate enlargement or prostate cancer and transurethral resection of bladder tumors (TURBT).
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tricyclic antidepressants

A group of medications used to treat depression that have been found to increase the serotonin levels in the body. In addition to improving mood at higher dosages, low doses of these medications interfere with pain impulses and promote sleep. These medications are also anticholinergic, and may help some IC patients with frequency and bladder spasm problems. The tricyclic medication Elavil® (amitriptyline) has become one of the first-line treatments for IC symptoms. Other tricyclic antidepressants used to treat IC include Tofranil® (imipramine), Sinequan® (doxepin), and Pamelor® (nortriptyline).
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trigger points

Localized painful areas which develop in muscles and connective tissues due to chronic spasms, contractions, or overuse. Nerves stimulated by chronically contracted muscles can release potent neurotransmitters, causing hypersensitivity and pain. Trigger points have been identified in the vaginal areas of IC patients and in women with vulvodynia. Pain from trigger points can be reduced by a special form of massage called myofascial release.
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trigone

The part of the bladder wall, shaped like an upside-down triangle, which contains the highest concentration of bladder nerves. The base of the triangle encompasses both ureters, and the apex, or tip, ends at or near the bladder neck where the urethra is attached.
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trigonitis

Inflammation of the trigone (base of the bladder). Patients given the diagnosis of trigonitis may actually have IC.
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tryptophan

An essential amino acid - one which is not manufactured by the body and must be obtained through the diet. Tryptophan is one of the main precursors or building blocks of the neurotransmitter serotonin.
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ureters

The two thin, muscular tubes about nine inches long which transport urine from the kidneys to the bladder. They enter the bladder at the top of the trigone.
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urethra

A small, tubular structure that enables urine to pass from the bladder out of the body. The female urethra is relatively short in length compared to the male urethra.
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urethral pressure profile (UPP)

One of the urodynamics tests which measures the changes in urethral pressure, used to assess how well the urethra functions in maintaining continence. In this test, a catheter is inserted into the bladder and withdrawn at a steady rate, revealing the pressure within the urethra, and therefore, the ability to hold urine or to urinate.
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urethral syndrome

A constellation of symptoms including urinary urgency, frequency and pain with urination. The diagnosis of urethral syndrome is controversial, and many urologists believe that this "syndrome" is really a mild form of IC.
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urethritis

Inflammation of the urethra. IC may be misdiagnosed as chronic urethritis.
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urethrocele

A hernia in which part of the urethra presses on or bulges through the vaginal wall.
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urge incontinence

See incontinence.
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urinalysis

A urine test done in the doctor's office that may indicate the presence of white blood cells, which can be a sign of infection. Does not identify the type of bacteria. Urinalysis can also identify the pH of the urine, as well as the presence of red blood cells, protein, and glucose, etc. Urinalysis can identify that bacteria are present in the urine, but it does not indicate the type of bacteria.
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urinary diversion

Surgical procedure in which urine is diverted away from the bladder by directing the ureters into a piece of bowel and out to the skin of the abdomen. Urine is then collected in an external bag. In a second type of diversion, an internal pouch is created from a segment of bowel. The ureters are connected to the new "internal pouch." Pouches used include the Koch, Indiana and Florida Pouch. Urine collects in the pouch and is emptied via catheter four to six times a day. In both of these procedures, the bladder may be removed or left in place. An orthotopic diversion, where the bladder is removed and a new bladder, constructed from the bowel and connected to the urethra is left in its place, is being performed in selected centers. Patients can void through the normal urethral channel and not need a bag or a catheter. Urinary diversion may result in serious complications including infections and chronic kidney damage over 15 or 20 years
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urinary tract

All organs and ducts involved in the production, release and elimination of urine, i.e. the kidneys, ureters, bladder, and urethra.
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urodynamic tests

Tests done in a urologist's office, intended to assess continence, or how well the bladder can hold urine. This series of tests includes cystometrogram, electromyography, residual urine test, uroflow, and voiding cystourethrogram.
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uroflow

Also called uroflowmetry. One of the urodynamic tests which measures the amount of urine flow and the efficiency of the bladder in emptying. This test assesses urethral obstruction or other causes of inefficient bladder emptying.
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urologist

A licensed physician who is trained to treat disorders of the urinary tract.
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urology

The branch of medicine which treats the urinary tract in both males and females.
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urothelial cells

The inner-most layer of cells of the bladder lining. Synonyms: surface cells, transitional epithelial cells.
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uterine prolapse

A condition in which the pelvic floor muscles are weak or damaged, usually during childbirth, allowing the uterus to slip from its normal position.
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vesicoureteral reflux

A condition in which urine backs up from the bladder into the kidneys, causing kidney damage.
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void

To empty urine from the bladder.
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voiding cystourethrogram (VCUG)

One of the urodynamic tests, in which an X-ray of a full bladder reveals its shape and capacity, its ability to store and empty urine, residual urine, and the existence of ureteral reflux. This is an x-ray of the bladder and urethra which is performed as the patient voids. The study reveals the shape and capacity of the bladder, as well as its capacity to empty. It also enables the evaluation of the neck of the bladder and urethra during urination. VCUG is often performed in conjunction with urodynamic evaluation and is called videourodynamics (VUDS).
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vulva

The outer genitalia or external parts of the female genital organs. Consists of the labia, the opening of the vagina, and the various glands.
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vulvodynia

Chronic vulvar discomfort or pain characterized by complaints of burning, stinging, irritation or rawness of the female genitalia. Burning sensations are the most common, but vulvodynia pain is highly variable. The condition varies in persistence and location. Pain may be constant or intermittent, localized or diffuse. In many cases of vulvodynia, pain occurs spontaneously. Vulvodynia has also occasionally been referred to as pudendal neuralgia, or hypersensitivity, of the vulva.

The four types of vulvodynia are described. Careful diagnostic evaluation is important in order to distinguish these conditions from each other and from others with similar symptoms and to choose the most effective treatment.

  • Vulvar vestibulitis - Inflammation around the "vestibule," or opening to the vagina. This condition may occur alone or in combination with other types of vulvar pain. Symptoms of vulvar vestibulitis include sensations of burning, dry, raw, or tight skin, and may range from mild to severe. Pain is usually caused by external touch, or by pressure caused by intercourse, tampon insertion, tight pants, bicycling or horseback riding, for example. A few patients, however, may have symptoms without touch or pressure. Some patients with vulvar vestibulitis only have discomfort with intercourse. Others are uncomfortable on a daily basis and find it difficult to sit or walk. Some women cannot tolerate intercourse, but others can, although there is usually some degree of discomfort. Women with severe, enduring pain may develop vaginismus, a spasm of the pelvic floor muscles that makes intercourse or tampon insertion difficult or impossible.
  • Dysesthetic vulvodynia - Vulvar pain caused by irritated or inflamed nerves. Pain may encompass the inner labia, or may extend beyond the vulva to the anus or groin area, or down the inner thighs. Some women experience sharp pains or deep aching. This type is most common in post-menopausal women and women with fibromyalgia, and may also be seen with interstitial cystitis.
  • Cyclic vulvovaginitis - The yeast Candida normally inhabits the mouth, vagina, intestinal tract, and skin. If Candida overgrows in the vagina or on the vulva, it can cause itching, burning, inflammation, and swelling. Candida may affect the vulva without causing any obvious vaginal discharge. Skin may tear or split from swelling. The cause of chronic Candida is unknown, but various theories have suggested an allergy to yeast or fermented products, immune suppression, or some type of autoimmune response to yeast. Symptoms may flare around the time of menses (hence, "cyclic").
  • Vulvar or mucous dermatoses - Skin disorders which occur on the vulva's membranes may cause chronic itching or burning. When scratched, these areas become inflamed, more irritated and hypersensitive, and can be caused, or made worse, by overuse of topical medications or frequent douching. This category includes several skin eruptions characterized by the term "lichen," which merely describes a tough, scaly, or peeling appearance. The most common is lichen simplex, but lichen sclerosis and lichen planus are two other skin problems which affect the vulva.

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Revised January 14, 2013