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To diagnose interstitial cystitis (IC), your doctor will need to rule out a number of other conditions that have similar symptoms, such as kidney stones, urinary tract infection, sexually transmitted infections, endometriosis and vaginal infection. She or he will take your patient history and ask you many questions about your urinary and pain symptoms. A careful physical exam will be done to rule out other conditions, and a urine sample will be taken to check for infection. A cystoscopy is often necessary to complete the diagnosis.

Cystoscopy with Hydrodistention

A cystoscopy is a telescopic examination of the bladder. This is an out-patient hospital procedure, which is usually done with a general anesthetic. A flexible tube with a fibreoptic camera, called a cystoscope, is inserted through the urethra and used to view the inner wall of the bladder. The cystoscope is used to fill the bladder with water. This stretches the bladder (hydrodistention) and allows the surgeon to have a clear view of the wall of the bladder.

The surgeon will look for evidence of IC, including glomerulations (tiny pinpoint spots of bleeding and/or bruising in the bladder wall) and ulcers, and measure how much fluid the bladder holds.  

Ulcers, called Hunner's ulcers, are larger sores where many epithelial cells have been destroyed. The presence of ulcers or glomerulations supports the diagnosis of IC. In some cases, the surgeon may also use the cystoscope to take a biopsy of the bladder wall for further testing.

After a full-bladder hydrodistention, you may have some abdominal pain, and your first voids following the procedure will likely be painful. You will require a few hours in the recovery room and can likely go home the same day with pain medication. Although some women have pain in the week following the procedure, 20 to 25 percent of women with IC find their symptoms improve following hydrodistention.

Pain and symptom relief can last for three to six months after the procedure. Hydrodistention may be used as a treatment for women who find that the procedure relieves their symptoms. This is called therapeutic hydrodistention.


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Interstitial Cystitis

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