At this time, there is no medical test that can say a person has IC/BPS. Also, there is no test to say a person does not have IC/BPS. To make a diagnosis, your health care provider will first decide whether the symptoms are typical of IC/BPS. Next, they need to rule out other health issues that might be causing the symptoms. Some believe that IC/BPS is present if a patient has symptoms and no other cause for those symptoms is found. Others believe that more tests are needed to find out whether the patient has IC/BPS.
Below are some ways your health care provider may find out if you have IC/BPS:
Your health care provider will ask you a number of questions about:
symptoms you are having
how long you have had the symptoms
how symptoms are changing your life
past health problems
current health problems
over-the-counter and prescription drugs you are taking
your diet, and about how much and what kinds of liquids you drink during the day
Physical and Neurological Exam
Your health care provider will examine you to look for the cause of your symptoms. In women, the physical exam will likely include your abdomen, the organs in your pelvis, and your rectum. In men, a physical exam will include your abdomen, prostate, and rectum. Your health care provider may also do a neurological exam to rule out any other problems. Patients with IC/BPS may have other mental health and/or anxiety disorders which may be linked to their condition.
Baseline Pain and Voiding Tests
Since the hallmark sign of IC/BPS is pain, your health care provider will conduct tests and ask you to fill out a series of questionnaires to find out your baseline pain value. The goal of the evaluation is to find pain location(s), intensity, and characteristics, and to identify factors that make pain or discomfort better or worse. Your health care provider will also ask how often you void.. A very low voiding frequency or high voided volume should prompt your health care provider to look for some other urological condition beside IC/BPS.
Your health care provider may run other tests to rule out health issues that may seem like IC/BPS. These include:
Urodynamic evaluation: This involves filling the bladder with water through a small catheter (tube to drain fluid from the body). This measures bladder pressures as the bladder fills and empties. In patients with IC/BPS the bladder has a small capacity and perhaps pain with filling.
Cystoscopy: Using a special tool, your doctor looks inside the bladder. This test can rule out other problems such as cancer. The doctor can see actual ulcers through the cystoscope in some patients with IC/BPS. If a person has symptoms of IC/BPS and cystoscopy shows ulcers, the diagnosis is fairly certain. Cystoscopy can also be performed in the operating room. If bladder stones, tumors or ulcers are seen during cystoscopy, the doctor can take care of them at the same time as the bladder biopsy, which is used to rule out other bladder diseases.
At this time, there is no clear answer about the best way to diagnose IC/BPS. However, if a patient has typical symptoms and a negative urine exam showing no infection or blood, then IC/BPS should be suspected.