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Early identification of interstitial cystitis may avoid unnecessary hysterectomy – Source: JSLS (Journal of the Society of Laparoendoscopic Surgeons) Jul-Sep 2009

Background: Interstitial cystitis [aka painful bladder syndrome] is a clinical syndrome characterized by symptoms of pelvic pain, urinary urgency and frequency, and nocturia [frequent nighttime urination].

It can be difficult to accurately identify interstitial cystitis because the symptoms overlap many other common gynecologic and urologic conditions. Patients with undiagnosed interstitial cystitis may undergo unnecessary procedures, including hysterectomy.

Methods: A PubMed literature search for articles dating back to 1990 was conducted on the topics of interstitial cystitis and hysterectomy. Further references were identified by cross-referencing the bibliographies in articles of interest.

Results: The literature review found that:

• Hysterectomy is performed more often in patients with undiagnosed interstitial cystitis than in patients with a confirmed diagnosis.

• Interstitial cystitis often coexists with conditions like endometriosis, for which hysterectomy is indicated.

• Many patients subsequently diagnosed with interstitial cystitis continue to experience persistent pelvic pain despite having had a hysterectomy for chronic pelvic pain.

• Careful history and physical examination can identify the majority of interstitial cystitis cases.

Conclusion:

• Interstitial cystitis should be considered prior to hysterectomy in women who present with pelvic pain or who experience pelvic pain after a hysterectomy.

• If interstitial cystitis is diagnosed, appropriate therapy may eliminate the need for hysterectomy.

Source: JSLS (Journal of the Society of Laparoendoscopic Surgeons) Jul-Sep 2009;13(3):350-7. PMID: 19793476, by Chung MK, Jarnagin B. Midwest Regional Center for Chronic Pelvic Pain, Lima, Ohio, USA. [E-mail: endosurgeon85@aol.com]