| Abstract: |
This chapter about interstitial cystitis (IC)/chronic pelvic pain is from a reference handbook that offers a comprehensive overview of urology, presented in outline and bulleted formats for ease of access in the busy health care world of hospital emergency rooms and outpatient clinics. The author notes that IC/chronic pelvic pain syndrome is a chronic, often unrecognized, lower urinary tract disease. The chapter covers epidemiology, pathophysiology, presentation, symptoms, diagnostic strategies, medical therapy, and surgical therapy. Primary symptoms of IC include one or more of the following: urinary frequency, urinary urgency, and pelvic pain. Other symptoms can include nocturia, dysuria, dyspareunia, and testicular, scrotal, and perineal pain. IC may be caused by bladder epithelial dysfunction, which leads to diffusion of urinary solutes, notably potassium, into the bladder interstitium, tissue injury, and inappropriate afferent nerve stimulation. Patient evaluation should include history with validated symptom questionnaire, physical examination, urinalysis, and urine culture. Additional tests that might be used include the potassium sensitivity test, cystoscopy, and urodynamics. The author concludes that urinary diversion should be considered only in patients with severe disease that is refractory to less invasive therapies. The chapter concludes with a list of references for additional reading. 2 figures. 54 references. |