Does My Patient "Really" Have IC?

This is something I've heard when teaching and training about how to treat interstitial cystitis (IC): "I don't think they really have IC."

What we usually mean by this is we feel their symptoms are stemming from pelvic floor dysfunction and central sensitization.

The AUA Definition of IC is simply: "An unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms of more than six weeks duration, in the absence of infection or other identifiable causes."

So this is really a description of symptoms.  If they have any kind of pelvic pain and urinary urgency/frequency without an infection or other medical cause, it is - by definition - correct to call it IC.

This is similar to how someone can have pudendal neuralgia....caused by pelvic floor dysfunction.
Vulvodynia....caused by pelvic floor dysfunction.
Coccydynia....caused by pelvic floor dysfunction.

Many of the diagnoses we treat are really just descriptors of the condition.  So just because pelvic floor dysfunction is the underlying cause, it doesn't mean they don't have the diagnosis!

Now, how you present this to your patient depends on their history with their symptoms and how they perceive the diagnosis.

But if they have those symptoms, among ourselves, we need to stop saying "I don't think this patient really has IC".

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Nicole and Jesse Cozean founded Pelvic PT Rising to provide clinical and business resources to physical therapists to change the way we treat pelvic health.   PelvicSanity Physical Therapy (www.pelvicsanity.com) together in 2016.  It grew quickly into one of the largest cash-based physical therapy practices in the country.

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