Dr. Chandrashekar.B.V.

Interstitial cystitis (IC), also known as painful bladder syndrome, is a difficult condition. It is difficult to arrive at the diagnosis of interstitial cystitis, though there are treatments that can make life easier, there is no long-term cure. Interstitial cystitis is a lifelong bladder problem, that causes pressure and pain below the belly button. Symptoms can be constant, or they may fluctuate. It causes painful and urgent trips to the bathroom. In severe cases, you may need to urinate about 40 to 60 times in a day.

What causes interstitial cystitis (IC)?

The bladder is a hollow, muscular organ that holds the urine your body needs to dispose. The reason why IC occurs isn’t that clear, but there a few ideas:
1. An issue with bladder tissue allows chemicals in your urine to irritate the bladder.
2. Chemicals that are released when there is an inflammation in your body can cause the symptoms.
3. The bladder can be attacked by your immune system
4. Substances in your urine can damage your bladder
5. Nerve problems can wreak havoc on your bladder

Signs and Symptoms

People suffering from IC don’t display the same symptoms. The symptoms keep changing, be it every day, every week or every month. Sometimes, the symptoms may entirely disappear without treatment. Some common IC symptoms include:
1. Bladder pressure and pain that worsens after the bladder gets filled with urine
2. Pain in your urethra (the tube that drains the urine from your bladder), pelvis, lower back and lower tummy
3. Women experience vaginal pain (or the area behind it) or in the vulva
4. In men, a sensation of pain in the penis, testicles, scrotum or the region behind the scrotum
5. The urge to urinate, even if you had urinated a few moments ago
6. Women experience pain during intercourse
7. Men experience pain after sex or during orgasm

One common symptom shared by all people suffering from IC is a swollen bladder. There are certain things that can worsen your condition. These include:
1. Certain drinks or foods
2. Physical or mental stress
3. Menstrual cycles

Bladder prolapse is a condition wherein a woman’s vaginal wall ceases to adequately support the urinary bladder. The front wall of the vagina gives support to the bladder under normal circumstances but when this wall weakens, it allows the bladder to droop and become prolapsed. This can lead to a wide range of medical problems such as urinary difficulties, stress incontinence (leakage of urine while coughing or sneezing), pain and discomfort, etc.

Prolapsed bladders are generally associated with menopause. Also known as cystoceles or fallen bladders, they are categorized into four different types depending on the extent to which the bladder has prolapsed.
Grade 1: This is the mild stage wherein a small portion of the bladder droops into the vagina.
Grade 2: This is the moderate stage in which the bladder droops far enough to reach the opening of the vagina.
Grade 3: This is when the condition becomes severe and the bladder protrudes from the body through the opening of the vagina.
Grade 4: This occurs when the bladder has completely prolapsed. The entire bladder protrudes outside the vagina and is normally associated with other forms of pelvic organ prolapse such as uterine prolapse (the sagging of the uterus from its normal spot) and rectocele (prolapse of the wall between the vagina and the rectum).

What are the causes of prolapsed bladders?
Following are the factors that lead to the condition of prolapsed bladders:

1. Menopause: The vaginal walls are known to become weak upon the onset of menopause. This occurs because the body inhibits the production of oestrogen, the hormone that renders strength to the muscles of the vagina. As a result, the bladder is no longer supported by the vagina.
2. Childbirth: The process of childbirth puts a tremendous amount of stress on the vagina and often leads to deterioration of the muscles of the vaginal wall. This in turn leads to the condition of prolapsed bladder.
3. Straining: Anything that puts strain on the walls of the vagina can lead to this condition. This includes lifting heavy objects, chronic constipation, obesity, excessive coughing and sneezing or any other factor that damages the pelvic floor.

What are the symptoms of a prolapsed bladder?
Symptoms of a prolapsed bladder vary from case to case, depending on the category and extent of the condition. Some of the most commonly experienced symptoms of the condition are as follows:
Tissue sticking out of the vagina (that may be tender and/or bleeding)

1. Frequent urge to urinate
2. Urinary incontinence (unwanted leakage of urine)
3. Pain during urination
4. Pain during sex
5. Frequent urinary tract and bladder infections
6. Pain in the vagina, pelvis, lower abdomen or lower back
7. Incomplete urination