What is the role of urodynamic studies in the diagnosis of interstitial cystitis/bladder pain syndrome (IC/BPS)?

Updated: Dec 04, 2020
  • Author: Eric S Rovner, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Urodynamic studies are not part of the routine evaluation for interstitial cystitis. Few urodynamic findings are consistent in patients with interstitial cystitis, and findings specific for the syndrome do not exist. On filling cystometry, most patients have increased sensation with a decreased volume at all filling intervals. Pain with bladder filling that reproduces the patients' interstitial cystitis symptoms is very supportive of a diagnosis of interstitial cystitis. Sphincter electromyography may show some increased activity caused by pain with bladder filling.

The prevalence of involuntary bladder contractions in patients with interstitial cystitis symptoms ranges from 0-14%; however, bladder contractions on filling cystometry studies are commonly cited as mitigating evidence against a diagnosis of interstitial cystitis, as per the NIDDK criteria. Volitional bladder contractions in patients with interstitial cystitis are quite similar to those in healthy persons.

Bladder compliance in patients with interstitial cystitis is usually normal. Postvoid residual volume should be minimal. Findings from pressure flow studies and free uroflow studies are usually unremarkable. True detrusor-sphincter dyssynergia excludes the diagnosis of interstitial cystitis.


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