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Tests and diagnosis
By Mayo Clinic staffIt can be difficult to detect interstitial cystitis because its signs and symptoms resemble those of other disorders.
To diagnose interstitial cystitis, your doctor will take your medical history and ask you to describe your symptoms. Your doctor may also request that you keep a bladder diary, recording the volume you drink and the volume of urine you pass. This information can be very useful for diagnosing interstitial cystitis.
Because urinary frequency and lower abdominal pain have many possible causes, your doctor needs to perform tests to rule out other conditions such as urinary tract infection, kidney stones, bladder cancer, sexually transmitted diseases, endometriosis, and vaginal infection in women or prostatitis in men.
Tests used to diagnose interstitial cystitis may include:
- Complete pelvic exam. During this exam, your doctor examines your external genitals, vagina and cervix and feels (palpates) your internal pelvic organs. Your doctor may also examine your anus and rectum.
- Urine test. A sample of your urine will be analyzed for evidence of a urinary tract infection.
- Potassium sensitivity test. In this test, your doctor places two solutions — water and potassium chloride — into your bladder one at a time. You're asked to rate on a scale of 0 to 5 the pain and urgency you feel after each solution is instilled. If you feel noticeably more pain or urgency with the potassium solution than with the water, your doctor may diagnose interstitial cystitis. People with normal bladders can't tell the difference between the two solutions.
- Cystoscopy. Doctors sometimes use this test to rule out other causes of bladder pain. Cystoscopy involves an examination of your bladder through a thin tube with a tiny camera (cystoscope) inserted through the urethra. Cystoscopy allows your doctor to see the lining of your bladder. In conjunction with cystocopy, your doctor may instill a liquid into your bladder to help measure your bladder capacity. This procedure, called cystodistension, is generally performed with anesthetics to reduce discomfort.
- Biopsy. During cystoscopy under anesthesia, your doctor may remove a sample of tissue (biopsy) from the bladder and the urethra for examination under a microscope. This is to check for bladder cancer and other rare causes of bladder pain.
Researchers are looking to develop tests that will help confirm the diagnosis of interstitial cystitis without an invasive procedure.
Sample Bladder Diary (PDF file requiring Adobe Reader)
- Interstitial cystitis/painful bladder syndrome. National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC). http://kidney.niddk.nih.gov/kudiseases/pubs/interstitialcystitis/. Accessed Dec. 9, 2008.
- Fitzgerald MP. Patient information: Painful bladder syndrome and interstitial cystitis. http://www.uptodate.com/home/index.html. Accessed Dec. 9, 2008.
- Hanno PM. Painful bladder syndrome/interstitial cystitis and related disorders. In: Wein AJ, et al. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/113536197-2/0/1445/13.html?tocnode=54300277&fromURL=13.html#4-u1.0-B978-0-7216-0798-6..50012-1_840. Accessed Dec. 9, 2008.
- Evans RJ, et al. Current diagnosis of interstitial cystitis: An evolving paradigm. Urology. 2007;69(suppl):64.
- Fitzgerald MP. Patient information: Treatment of painful bladder syndrome and interstitial cystitis. http://www.uptodate.com/home/index.html. Accessed Dec. 9, 2008.
- Moldwin RM, et al. Rational approaches to the treatment of patients with interstitial cystitis. Urology. 2007;69(suppl):73.
