Doctors use a combination of tests, including urinalysis, cystoscopy, urine culture, and bladder wall biopsy to diagnose interstitial cystitis. For males, they may also examine prostate secretions.
A note about sex and gender
Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.
Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic bladder condition that can be challenging to diagnose. IC/BPS affects 4–12 million people in the United States. Despite the condition’s prevalence, medical experts do not yet know its exact cause.
Diagnosing IC/BPS is often challenging because the symptoms mimic those of other conditions, including urinary tract infections (UTIs), sexually transmitted infections, and urinary tract cancer.
To rule out other conditions, a urologist may perform multiple tests and diagnostic procedures to find the cause of a person’s symptoms.
This article explains some common symptoms of IC/BPS and the tests doctors use to diagnose it.
A urinalysis checks a person’s urine for signs of a UTI or kidney infection. It can also help detect more serious conditions, such as diabetes and kidney disease.
The results of a urine test cannot determine whether a person has IC/BPS. However, they can help narrow down the possible causes of a person’s symptoms.
A urine culture is a laboratory test that identifies different bacteria and other microorganisms in a urine sample. This test takes
A urine cytology test screens a person’s urine for abnormal or cancerous cells.
Urologists may order these tests if a person:
- experiences frequent burning or stinging sensations during urination
- has blood in their urine
- experiences pain while urinating
A cystoscopy is a diagnostic procedure in which a urologist inserts a thin tube called a cystoscope into a person’s urethra.
This tool allows the urologist to view the bladder and urethra to look for inflammation or swelling, bladder ulcers, and signs of infection.
In some cases, the urologist may perform a cystoscopy with hydrodistension, which involves stretching the bladder by filling it with fluid. This procedure can be painful, and healthcare professionals will usually give a person anesthesia before performing it.
According to the Interstitial Cystitis Association, cystoscopy with hydrodistension is no longer the standard method of diagnosing IC/BPS.
However, this procedure can help identify Hunner’s lesions, which are painful ulcers or patches that appear on the bladder wall in 5–10% of people with IC/BPS.
A bladder wall biopsy is a diagnostic procedure in which a urologist removes a small sample of the bladder tissue for analysis under a microscope. Healthcare professionals typically perform this procedure in conjunction with a cystoscopy.
A biopsy is not necessary to confirm a diagnosis of IC/BPS, but it can help rule out bladder cancer.
Healthcare professionals may ask males who are experiencing symptoms of IC/BPS to undergo an examination of prostate secretions to rule out prostatitis — an infection and inflammation of the prostate gland that can have similar symptoms to IC/BPS.
During this exam, the doctor inserts their finger into the person’s rectum and presses each side of the prostate gland to stimulate the release of prostatic fluids. Healthcare professionals then collect these fluids for examination under a microscope.
Potassium chloride sensitivity testing (PST) is a controversial diagnostic method for IC/BPS.
This test involves instilling a person’s bladder with water and potassium chloride solution, a known irritant. People who experience pain during or after this test are PST-positive.
According to a team of experts from the American Urological Association, PST is painful and can trigger a severe reaction in people with IC/BPS. The panel concluded that the risks outweigh the benefits.
People should consult a doctor about the risks and benefits of a PST.
Symptoms of IC/BPS vary from person to person, but common symptoms include:
- Frequent urination: In serious cases, a person may urinate up to 60 times per day. In mild cases, frequent urination may be the only symptom.
- An urgent need to urinate: A person may feel a sudden, strong need to urinate. They may also experience spasms, pressure, or pain.
- Pain: Males may experience testicular, scrotal, and perianal pain. Females may experience pain in the lower abdomen, urethra, and vaginal area.
- Pain during intercourse, or dyspareunia: Females may experience pain during intercourse. Males may experience pain when they ejaculate.
Some people with IC/BPS may experience pain but not urgency or frequency, while others may experience a combination of symptoms.
IC/BPS can be debilitating and lead to poor quality of life.
People experiencing symptoms of IC/BPS should discuss the next steps with a healthcare professional. A person may receive a referral to a urologist for additional tests or treatment.
IC/BPS is a chronic bladder condition that can affect anyone of any sex. People who suspect that they have IC/BPS should contact a doctor for testing and treatment.
Although IC/BPS currently has no cure, treatment options are available to help people manage their symptoms and prevent flares. Getting a diagnosis is the first step toward relief.