Unit Six : Investigations

Investigations usually do not yield much in terms of diagnosis, but are useful in excluding the confusable disorders

Urinalysis   using a standard dipstick method, one can exclude aciduria (persistent pH below 5.5), infections (absence of nitrites, leucocyte esterase and pus cells) , stone disease (absence of blood and  RBCs). Urine culture should be done if the dipstick analysis is suggestive of infection.

Ultrasound KUB, (and pelvis in women) along with post void residual urine should be done to exclude the pathologies of pelvic organs, which can mimic the symptoms of IC/BPS.

Uroflometry may be required if the patient reports obstructed voiding. This is also a useful tool to assess pelvic floor spasm as happens in many patients with anxiety disorder.

 Urodynamic evaluation should be considered if there is a clinical suspicion of dysfunctional voiding which is corroborated with abnormal uroflometry.

Potassium sensitivity test  which was initially designed to recreate the pain by instilling Potassium chloride solution into the bladder has largely been given up

Anaesthetic challenge test, in which lignocaine, a local anesthetic agent is instilled into the urinary bladder and almost instant reduction in pain is noticed. 20 ml of 2{9802d47d6d88dfb86fe34586c63757e96508e528afd0c0bb3af5da2789c058d3} lignocaine is instilled through a small caliber catheter (infant feeding tube) in office setting and the reduction in pain is noted over a Visual Analog Scale (VAS).

Lets understand the Cystoscopy findings in these patients >>