From the Research
Interstitial cystitis is a relatively rare condition in the pediatric population, with a prevalence that is not well-established but considered to be low, and its diagnosis and management can be challenging due to overlapping symptoms with other urinary disorders and the difficulties in obtaining accurate patient history from younger patients. The condition is often characterized by symptoms such as urinary frequency, urgency, and bladder or pelvic pain, which can significantly impact the quality of life of affected children. Diagnosis typically involves ruling out other conditions through urinalysis, urine culture, and sometimes cystoscopy with hydrodistention, as noted in studies such as 1.
Treatment approaches for pediatric interstitial cystitis include:
- Dietary modifications to avoid bladder irritants
- Physical therapy for pelvic floor dysfunction
- Medications such as amitriptyline, pentosan polysulfate sodium, or hydroxyzine, with dosages adjusted for weight in children
- Bladder instillations with dimethyl sulfoxide (DMSO) or heparin in refractory cases, as discussed in 2 and 3
The condition appears to have a multifactorial etiology involving bladder epithelial dysfunction, neurogenic inflammation, and possibly autoimmune components, which explains the chronic nature of symptoms, including urinary frequency, urgency, and bladder/pelvic pain, as suggested by the findings in 4 and 5. Early recognition and multimodal treatment are essential for managing this chronic condition in children, aiming to reduce morbidity, mortality, and improve quality of life. Given the most recent and highest quality evidence, pentosan polysulfate sodium is considered a beneficial treatment option for interstitial cystitis, as evidenced by its efficacy in improving symptoms in patients with this condition, as shown in 4.