Endometriosis and Interstitial Cystitis
Historically, 19th and 20th century gynaecologists and medical practitioners viewed endometriosis as a condition exclusively affecting the reproductive organs, with cases diverting from this viewpoint being seen as unrelated. However, it has been becoming increasingly obvious over decades of clinical practice that endometriosis is a broad-spectrum inflammatory condition that can affect the entire body. Interstitial Cystitis is a condition in which the bladder retains urine due to a blockage, inflammation, and issues with the nervous or immune system.
This condition is linked to Bladder endometriosis, a location for extra-pelvic endometriosis, and can also involve the ureter, kidney, and urethra. Also referred to as UTE (urinary tract endometriosis) or painful bladder syndrome, this pathology comes in a close second (after endometriosis of the gastrointestinal tract) among instances of extra-pelvic endometriosis. These growths can interfere with the functionality of the patient’s urinary tract, causing the development of interstitial cystitis.
However, due to half of UTE cases being asymptomatic, it is difficult to establish a firm prevalence rate regarding Bladder Endometriosis, as well as its effect on patients developing IC. Hence, this invisibility and lowered clinical detection results in lowered diagnosis rates among those suffering from both pathologies. The specific location of UTE growths follow in this order amongst the diagnosed population; bladder, 85%; ureter, 10%; kidney, 4%; and urethra, 2%. Specifically, Bladder Endometriosis concerns endometriotic tissue implantation within the bladder’s detrusor muscle. Furthermore, tissue growth can either be partial or full thickness.
Patients with Interstitial Cystitis often experience chronic pain in the pelvis, groin, and lower back, as well as frequent urination, incontinence, and pain during sex. These symptoms can worsen if a patient with IC develops a urinary tract infection. This possibility can be particularly risky as both conditions have overlapping symptoms, leading to patients ignoring or dismissing the infection’s effects until the severity increases significantly.
Although studies are still inconclusive regarding all exact causes of the presence of endometriosis implants within the urinary tract, there is sufficient evidence to indicate a genetic link for this pathology. Interestingly, some cases have also shown an iatrogenic link to UTEs, in that bladder endometriosis is more commonly seen in patients after they have undergone Caesarean sections. Treatment for Endometriosis-caused Interstitial Cystitis includes laparoscopic/robotic excision of growths, reconstruction and repair of the urinary structures or partial cystectomy, and pain management.
Sources
https://www.medicalnewstoday.com/articles/321439
https://nancysnookendo.com/interstitial-cystitis-evil-twin-of-endometriosis/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3015716/
https://www.lagyndr.com/endometriosis/endometriosis-and-interstitial-cystitis-i-c/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7650710/