Interstitial Cystitis / Bladder Pain Syndrome (IC/BPS) Diagnosis and Treatment in New Jersey

A sample of your urine is checked for infection, traces of blood and other signs that can help diagnose the cause of your interstitial cystitis/bladder pain syndrome.

After you urinate into a container, your doctor will measure the urine left in your bladder using an ultrasound. A large amount of urine left in your bladder may mean a blockage in your urinary tract or a problem with bladder nerves or muscles.

You have access to the area’s most advanced testing for interstitial cystitis/bladder pain syndrome at Hackensack Meridian Health. We are the only provider in the area offering video urodynamic testing. Video urodynamic testing allows us to learn more about your urine flow and the strength of the pelvic muscles that surround the urethra, vagina and rectum. 

Your doctor may order an ultrasound to examine the structure of your bladder and rule out any structural abnormalities in your abdomen or pelvic area that could cause symptoms.

Cystoscopy may be recommended by your pelvic medicine specialist to gauge the health of your bladder and determine what may be contributing to your interstitial cystitis/bladder pain syndrome. 

How Cystoscopy Works

• A flexible, lighted tube is moved through the urethra and into the bladder.
• Special tools are used by the urologist to view the area. 
• If your urologist sees a problem, she may be able to treat it during the test. 
• The outpatient procedure usually is done in the office and is not painful.

Making changes to your diet, such as eliminating coffee, tea, or acidic foods and drinks, has been shown to relieve symptoms of IC/BPS in some patients. 

Some patients with IC/BPS have high tone pelvic floor dysfunction, meaning you have very tight and painful muscles of the pelvic floor. You may be treated by a specialized physical therapist to alleviate the muscle tightness causing your pain. 

A number of oral medications can be effective for treating IC/BPS by relieving pain, relaxing your bladder muscle and protecting your bladder from irritation.

A medicated solution that relieves bladder irritation can be applied directly to your bladder through a catheter. The medication then sits in the bladder for a short period of time. This is done in the office on a weekly basis for six weeks.

If lesions or ulcers are discovered as the cause of your bladder pain and discomfort, your urologist may perform fulguration. Your urologist inserts a cystoscope into the bladder and then uses a laser or electrocautery to destroy the diseased tissue. This is done under sedation in the operating room.

If lesions or ulcers are discovered as the cause of your bladder pain and discomfort, your urologist may inject a steroid into the ulcer through a cystoscope. This is done under sedation in the operating room. 

Injections of Botox® also can be used to help your bladder relax and allow it to fill with more urine before you have the urge to go. For people with severe bladder pain, this procedure may be done in the operating room under sedation.

For interstitial cystitis/bladder pain syndrome that does not respond to treatment, robotic or minimally invasive surgery may be performed to offer relief. Surgery may include removal of the bladder with reconstruction of the urinary tract. This is considered the last resort for treating  severe IC/BPS.

You have access to New Jersey’s largest and most successful program for robotic urology surgery at Hackensack Meridian Health. We are the only one to offer a single-port approach, which means the surgical instruments and a camera are inserted through a single incision. 

Learn more about the benefits of Robotic Urology Surgery

Sacral neuromodulation (SNM) can be effective for treating interstitial cystitis/bladder pain syndrome for some patients.  A type of “bladder pacemaker,” SNM stimulates the sacral nerve which controls the muscles and other nerves responsible for your bladder.

• During a procedure under conscious sedation, a small device is implanted under the skin near your buttocks. It is connected to wires placed near the sacral nerve, just above the tailbone. 
• Once implanted, the SNM device sends painless electrical pulses to the sacral nerve.

Symptoms can vary from person to person and may fluctuate in intensity. The most common symptoms include:

• A persistent and urgent need to urinate.
• Frequent urination in small amounts, sometimes up to 60 times a day in severe cases.
• Pain in the pelvis, lower abdomen, or the area between the vagina/scrotum and anus.
• A feeling of pain or discomfort as the bladder fills, which may be temporarily relieved by urinating.
• Pain during sexual intercourse.

Diagnosing BPS/IC is often a "diagnosis of exclusion," which means your doctor must first rule out other conditions with similar symptoms, such as UTIs, bladder cancer, or endometriosis.

The diagnostic process at Hackensack Meridian Health involves a thorough evaluation that may include a medical history review, a pelvic exam, urine tests, and a cystoscopy, where a thin, lighted scope is used to look inside the bladder for signs of inflammation or pinpoint hemorrhages (glomerulations) that are characteristic of BPS/IC.

• Lifestyle and Dietary Changes: Identifying and avoiding trigger foods and beverages like caffeine, alcohol, and acidic foods.
• Pelvic Floor Physical Therapy: To help relax pelvic muscles and relieve tenderness.
• Oral Medications: Various medicines to relax the bladder, reduce inflammation, or block pain signals.
• Bladder Instillations: Placing a soothing medicinal solution (like heparin or dimethyl sulfoxide) directly into the bladder to coat and protect its lining.
• Advanced Therapies: For more severe cases, options may include nerve stimulation (InterStim™) or Botox® injections into the bladder muscle.

Hackensack Meridian Health offers treatment for IC/BPS at locations across New Jersey — from Bergen, Essex, Hudson, Passaic, Sussex and Union counties in the north to Middlesex, Monmouth, Burlington and Ocean counties in the central and south. Find a care location now.