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Kenyatta University *
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EAE 410
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Medicine
Date
Nov 24, 2024
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Title: Interstitial Cystitis: A Comprehensive Review
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Introduction
In medicine, interstitial cystitis (IC) or bladder pain syndrome can be defined as a chronic
inflammatory condition of the bladder which presents with symptoms such as pelvic pain,
urgency and frequency. It drastically impacts the affected person’s quality of life. The objective
of this poster is to give a review about IC, incorporating its bleakness and mortality, etiology,
pathophysiology, indicative testing performance demonstrations requirements indicative rules
and proof based administration systems.
Morbidity and Mortality
IC is a common disease, affecting many people globally
(Jiang, et al., 2021)
. Although it is not a
life-threatening condition, the chronic and symptomatic nature of interstitial cystitis can result in
significant morbidity; such as decreased quality of life, psychological distress and damage to
relationships.
Etiology
The exact etiology of IC is unknown, but it’s thought to be complex chart. Multi Tentative
factors encompass urothelial dysfunction, defective barrier functions of the bladder epithelium,
autoimmune processes, neurogenic inflammation and genetic susceptibility
(Kopp Kallner, et al.,
2019)
. A range of factors, including urinary tract infections, bladder trauma, hormonal
fluctuations and specific foods or drinks can intensify symptoms in those who are susceptible.
Pathophysiology
With chronic inflammation and increased bladder epithelial permeability, resulting in urothelial
damage and sensory nerve activation (Chermansky & Guirguis, 2022). This results in raises
perception of pain, urinary urgency, frequency as well as nocturia (Homma, 2019). The chronic
inflammatory process engages different inflammatory genic mediators like cytokines,
chemokines and mast cells.
Diagnostic Testing
The diagnosis of IC is difficult and based on clinical assessment (Masterson, et al., 2023). The
purpose of diagnostic testing is to exclude other disorders that can produce the same symptoms
(Jhang, et al., 2021). Routine diagnostic tests are cysto/hydro, UA, cytology and PST. It may be
done occasionally for biopsy clarification.
Clinical Presentation
In general, IC patients will have pelvic pain, loss of bladder control going forward (urge
incontinence), more frequent voiding of smaller amounts (frequency), having to go at night at
least 1-2 times but usually many more with feeling like they have to rush and force it out , and
dyspareunia
(Nygaard, et al., 2020)
. Symptoms can vary widely and have a big impact on daily
life (Chen, et al., 2022). It is essential to consider both objective findings, such as bladder
capacity and urodynamic studies, and subjective reports from the patient during the clinical
assessment.
Diagnostic Criteria and Management
The criteria for diagnosing IC have changed over the years. The ESSIC criteria are the most
accepted. The management of IC is multimodal in nature, incorporating lifestyle modifications,
and pharmacotherapy and intravesical therapies with surgical interventions as a last resort (Asif
et al., 2022). The treatment plans have to be personalized, taking into account the severity of
symptoms and patients' response to different therapies.
Standardized Policies and Procedures, Chart Review Processes, and Supervising Physician
Agreements
In some states, APRNs practicing in urology and women’s health will have additional state-
specific requirements for the standardized policies and procedures, chart review process, and
supervising physician agreement (Abernethy & Tsuei 2021). The aim of these requirements is to
make sure care is delivered safely and effectively. Similar policies and agreements can be located
on state board of nursing websites or professional organization resources.
References
Abernethy, M. G., & Tsuei, A. (2021). The bladder microbiome and interstitial cystitis: is there a
connection?. Current Opinion in Obstetrics and Gynecology, 33(6), 469-473.
https://www.ingentaconnect.com/content/wk/coogy/2021/00000033/00000006/art00009
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Asif, A. H., Nair, A., Aldhubiab, B., Nagaraja, S., Meravanige, G., Asdaq, S. M. B., ... & Noor, S.
D. (2022). Interstitial Cystitis-Critical Assessment of Current Treatment and Opportunities for
Nanodelivery. INDIAN JOURNAL OF PHARMACEUTICAL EDUCATION AND
RESEARCH, 56(3), 636-645.
https://www.researchgate.net/profile/Anroop-
Nair/publication/361712400_Interstitial_Cystitis-
Critical_Assessment_of_Current_Treatment_and_Opportunities_for_Nanodelivery/links/62c38b
e93f38b17066d438d9/Interstitial-Cystitis-Critical-Assessment-of-Current-Treatment-and-
Opportunities-for-Nanodelivery.pdf
Chen, A., Shahiyan, R. H., & Anger, J. T. (2022). Interstitial cystitis/bladder pain syndrome
treatment: a systematic review of sexual health outcomes. Sexual Medicine Reviews, 10(1), 71-
76.
https://academic.oup.com/smr/article-abstract/10/1/71/6880370
Chermansky, C. J., & Guirguis, M. O. (2022). Pharmacologic management of interstitial
cystitis/bladder pain syndrome. Urologic Clinics, 49(2), 273-282.
https://www.urologic.theclinics.com/article/S0094-0143(22)00003-9/abstract
Homma, Y. (2019). Interstitial cystitis, bladder pain syndrome, hypersensitive bladder, and
interstitial cystitis/bladder pain syndrome–clarification of definitions and relationships.
International Journal of Urology, 26, 20-24.
https://onlinelibrary.wiley.com/doi/abs/10.1111/iju.13970
Jhang, J. F., Hsu, Y. H., Jiang, Y. H., Ho, H. C., & Kuo, H. C. (2021). Clinical relevance of
bladder histopathological findings and their impact on treatment outcomes among patients with
interstitial cystitis/bladder pain syndrome: An investigation of the European Society for the study
of interstitial cystitis histopathological classification. The Journal of Urology, 205(1), 226-235.
https://www.auajournals.org/doi/abs/10.1097/JU.0000000000001334
Jiang, Y. H., Jhang, J. F., Hsu, Y. H., Ho, H. C., Wu, Y. H., & Kuo, H. C. (2021). Urine
biomarkers in ESSIC type 2 interstitial cystitis/bladder pain syndrome and overactive bladder
with developing a novel diagnostic algorithm. Scientific Reports, 11(1), 914.
https://www.nature.com/articles/s41598-020-80131-5
Kopp Kallner, H., Elmér, C., & Altman, D. (2019). Urodynamics as a prognosticator of
mirabegron treatment outcomes. Gynecologic and obstetric investigation, 84(5), 472-476.
https://karger.com/goi/article/84/5/472/161436
Masterson, J. M., Castañeda, P. R., & Kim, J. (2023). Pathophysiology and Clinical Biomarkers
in Interstitial Cystitis. Urologic Clinics, 50(1), 39-52.
https://www.urologic.theclinics.com/article/S0094-0143(22)00066-0/abstract
Nygaard, C. C., Tsiapakidou, S., Pape, J., Falconi, G., Betschart, C., Pergialiotis, V., ... & in
Urogynaecology, S. (2020). Appraisal of clinical practice guidelines on the management of
obstetric perineal lacerations and care using the AGREE II instrument. European Journal of
Obstetrics & Gynecology and Reproductive Biology, 247, 66-72.
https://www.sciencedirect.com/science/article/pii/S0301211520300580