Interstitial Cystitis/Painful Bladder Syndrome

Alis Kolter Panzera, MSN, CRNP

Disclosures

Urol Nurs. 2007;27(1):13-19. 

In This Article

Symptoms

The primary symptom of PBS/IC includes the presence of abnormal urinary sensory urgency (the sensation of having to urinate immediately), which may or may not be accompanied by pain, pressure, or spasm. This sensation of urgency leads to urinary frequency. The average patient with PBS/IC voids approximately 16 times per day; voided volumes are usually less then normal, with an average of 106 ml per void (Tchetgen, Rackley, & Abdelmalak, 2005). Nocturia frequently accompanies daytime urinary frequency and tends to increase as the severity of PBS/IC increases. Patients may also report bladder pain located suprapubically, vaginally, in the perineum, low back, or in the medial aspects of the thighs (Parsons, 2004). This pain is often described as being relieved by voiding and often recurs with bladder filling.

Symptoms initially present with a subacute onset. Next, a rapid peak in symptom severity occurs, followed by a plateau phase, which may include a series of exacerbations and spontaneous remissions; these episodes are often referred to as flare-ups (Bradley & Singh, 2000). PBS/IC is an "invisible" illness as patients often appear "healthy" while experiencing constant, unremitting pain. Because there is no outward or visible source for this suffering, they are often faced with unattainable expectations from family, friends, and co-workers. PBS/IC has the potential to negatively affect every aspect of a patient's life: physical, emotional, psychological, social, and economic (Ratner & Perilli, 2003).

Flares

Emotional or physical stress is commonly reported as a factor that exacerbates symptoms. Although many patients experience some or all of these symptoms, others present in an atypical fashion. For example, some report muscle and joint pain, migraines, allergic reactions, and gastrointestinal problems, in addition to some of the common PBS/IC symptoms described previously (Interstitial Cystitis Association [ICA], 2005a). The adverse impact of PBS/IC cannot be overstated, especially when the condition has been allowed to continue over time. Adverse consequences can be severe and wide ranging, including sleep deprivation, travel and dietary restrictions, and avoidance of sexual intercourse (Simon, Landis, Erickson, Nyberg, & the Interstitial Cystitis Data Base Group, 1997). Menstruating women may notice an increase in symptoms prior to their menses (Chung, Chung, & Gordon, 2005; Wysocki, Smith, & Dell, 2005). Patients with PBS/IC may also notice an increase in symptoms related to the consumption of specific foods especially coffee, alcohol, carbonated drinks, citrus, tomatoes, and chocolate (Erickson & Davies, 1998; Wysocki et al., 2005).

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