Incontinence vs. Interstitial Cystitis: Which One Is It?

Health Professional

Let me start off by saying that incontinence is a completely different medical problem from Interstitial Cystitis (IC for short). I have often been asked to talk about IC during an incontinence lecture. There are many overlapping symptoms, and many people have both, but hear this now- they are completely different I have been reluctant to discuss IC in this SharePost because they are not the same, but I thought I could address the differences here.

Interstitial Cystitis is a syndrome that I loosely refer to as "painful bladder syndrome." It has a very large spectrum of symptoms that often start off annoying and can travel the road to end-stage bladders, which can be debilitating. The following is a very brief and simplified explanation of a very complex medical condition.

Often, symptoms start with urinary frequency and urgency. Many people experience pain over their bladder especially when the bladder is filling, and often relieved after voiding. Voiding itself can be painful, however.

Many people get mild to severe bladder spasms. Over time people's bladders can get fibrotic and actually lose capacity and the ability to store an appropriate amount of urine. Treatments are pretty variable, but the mainstay usually starts with a class of medications called anticholinergics.

Anticholinergics are the medications used in overactive bladder treatments, and this is why many people think incontinence and IC are the same. I know I will probably get a lot of angry replies when I state this, but the majority of people with Interstitial Cystitis do not have incontinence. Some do, I agree, but most people do not. Again, in general, IC is a painful syndrome that can cause urgency and frequency along with other bladder symptoms.

To confuse the picture more, both women and men get IC. For a very long time, IC was only recognized as a disease that affected women. Men were diagnosed with an "analogous" disease called chronic prostatitis. We are realizing that men can also be afflicted with IC, but now it is called Chronic Prostatitis/Chronic Pelvic Pain Syndrome. The symptoms are the same, but can show up differently. For instance, men tend to have more pain with orgasm, where women more often have pain with intercourse and penetration.

Treatment for IC, as mentioned before, is often initially treated with anticholinergic medications. That is about all IC has in common with incontinence and overactive bladder. From this point, there are many different approaches to treating IC. There is only one FDA approved medication for Interstitial Cystitis, but there are many agents used for additional treatment. There are diet recommendations, as well as behavior modification treatments too.

I hope you find this information useful. I really want to emphasize that if you are having symptoms of urgency, frequency or incontinence, you really need to be evaluated by a physician to figure out the cause. You may think you have one thing going on, but it could be something else.