1. Ruling out Other Causes
The symptoms you may feel with interstitial cystitis, particularly urinary frequency and a painful, burning sensation upon urination, are typical of other bladder problems. The most common of these is a urinary tract infection (cystitis), but other diseases exhibiting IC-like symptoms may include bladder stones (urolithiasis), carcinoma of the bladder, gynecological disorders like endometriosis, ectopic pregnancy, fibroids or ovarian tumors, kidney disease (renal tuberculosis), neurological disorders (multiple sclerosis), pelvic-floor dysfunction (PFD) and sexually transmitted diseases. Urethrocele (bladder hernia into the vagina), cystocele (tissue growth around the urethra) and prostatitis can also cause similar symptoms. In order to diagnose interstitial cystitis, your doctor must first rule out these other diseases through examination. Initial diagnostic tests performed on you may include a urine culture and urinalysis to test for bacteria and signs of infection and a prostatic-fluid culture for men.
2. Cystoscopy for a View From the Inside
The standard diagnostic procedure for interstitial cystitis, once bacterial infection has been ruled out, is a cystoscopy with hydrodistention. In this procedure, which would be performed under general anesthesia, your bladder would be filled to capacity with water or gas. This would allow your urologist to insert a small, telescopic, fiber-optic camera through your urethra and into your bladder in order to examine it from the inside. Your doctor will be looking for tiny hemorrhages called glomerulations that are found in 95 percent of IC sufferers but which can only be seen if the bladder is distended.
Scars, lesions and small epithelial ulcerations, called Hunner's ulcers, may also be found in the course of your cystoscopy. In the presence of ulceration, a tissue sample may be removed and biopsied in order to check for the presence of cancerous cells or disorder-causing mast cells. Even if glomerulations or Hunner's ulcers are not detected, your cystoscopy may reveal other causes of bladder irritation, which may mimic the symptoms of IC. Although the bladder distention required for your cystoscopy to be performed is so painful that it must be performed while you are under general anesthesia, the distention of your bladder may have therapeutic results, as it can temporarily alleviate the pressure and pain you feel with interstitial cystitis.
3. The New Test for Interstitial Cystitis
The newest test, used not only to look for interstitial cystitis, but also to evaluate your potential response to treatment options that affect your bladder lining, is the potassium chloride (KCl) sensitivity test, also called the Parsons test. In this test, a catheter is used to fill your bladder with a potassium chloride solution that can reveal any defects in your bladder wall. This is an outpatient test that can be performed in your doctor's office and usually takes less than 5 minutes to complete. The test may be mildly uncomfortable, but your discomfort will not last long, and you'll be able to resume your daily activities when you leave your doctor's office.
