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12.4: Diagnosis

  • Page ID
  • Usually confirmed on cystoscopy (under general or regional anaesthesia): Petechial bleeding is seen from the bladder wall (particularly after second filling of the bladder with irrigation fluid). There is usually a small bladder capacity and rarely an area of ulceration of the bladder wall (Hunner’s ulcer).

    Differential Diagnosis

    IC is a diagnosis of exclusion.

    1. Cystitis – urine dipstick and culture
    2. TB – urine for AFBs and TB culture
    3. Bladder carcinoma (particularly CIS) – urine cytology
    4. Bladder stone – U/S and cystoscopy
    5. Pelvic infection
    6. Endometriosis Intravesical Potassium Test If instillation of a solution with high potassium concentration reproduces the patient’s pain this is diagnositic of IC.