Diagnosing Complicated IC/BPS Cases

Some cases of interstitial cystitis/bladder pain syndrome (IC/BPS) are complicated and may required additional diagnostic testing. Your doctor may do additional testing, if there are signs and symptoms of other problems, such as incontinence, overactive bladder, blood or pus in the urine, endometriosis, or gastrointestinal conditions. For men, a misdiagnosis of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) can also make it more challenging to diagnosis IC/BPS.

For these cases, additional diagnostic testing may be required such as:

• Urodynamics, tests that help healthcare providers better understand how your bladder, urethra, and sphincter muscles are performing, can help doctors diagnose complicated cases and make decisions about treatment options.
• Cystoscopy with Hydrodistention is needed right away if blood in the urine brings the possibility of bladder cancer into play. This test also allows urologists to treat Hunner’s lesions, treatment that can be very effective for patients who have them.

There are no clinical standards for urodynamic tests findings and IC/BPS. The same is true for the results of cystoscopy and hydrodistention in most IC/BPS patients. We now know that glomerulations, pinpoint hemorrhages in the bladder wall, are also present in patients without IC/BPS symptoms and those with other conditions such as endometriosis and undifferentiated pelvic pain. The only exception is for the finding of Hunner’s lesions which provides a definitive diagnosis of IC/BPS for a small percent of patents.