Last Saturday Claudio Amendola, during the broadcast of Canale 5 “very true“, he revealed in tears that his wife (for 25 years), Francesca Neri, suffers from interstitial cystitis. A chronic disease that causes her severe pain that prevent her from living her days with serenity. In 2015, Neri herself was ill, but without specifying what pathology it was: since that moment the actress and producer has decreased her film commitments and her public releases. After six years of silence, Neri has decided to get naked and explained better what disease he suffers, heralding the release of a book entitled “Like living flesh“(Published by Rizzoli) in which he tells in great detail the years lived in the isolation caused by interstitial cystitis.
“The acute phase – said Neri – lasted three years, but even now I have not overcome it, because it does not heal. You learn to manage it and not to provoke it so that it is not disabling ”. But with what symptoms does interstitial cystitis manifest itself? How is the disease diagnosed? And what are the therapeutic treatments? To answer our questions is Prof. Rocco Damiano, Full Professor of Urology at the University Magna Graecia Catanzaro, and Head of Resources and Communication of the Italian Society of Urology (SIU).
Prof. Damiano, what is interstitial cystitis?
“Interstitial cystitis (IC) is a bladder disease with symptoms involving multiple abdominal-pelvic areas. It is also known as “Bladder Pain Syndrome” (BPS) and is characterized by localized bladder pain accompanied by at least one other symptom, such as a feeling of discomfort and weight in the bladder area, which has persisted for at least six weeks. Sometimes there is worsening of pain with bladder filling and a high urinary frequency during the day and / or at night. The disease is often associated with cognitive consequences or negative emotions, as well as with sexual dysfunction. There is no evidence of infection or other obvious local pathology and the diagnosis is often by exclusion “.
With what symptoms does it manifest itself?
“Interstitial cystitis begins with bladder pain and an increase in the day and night voiding frequency. The pain or feeling of weight that characterizes it can worsen with bladder filling. Furthermore, sexual activity is painful due to the contiguity of the inflamed bladder with the vagina. Symptoms of interstitial cystitis are recurrent, and persistent in some patients, and can be more or less severe. Many people take years to get a diagnosis. This is because the symptoms are often associated with pathologies in other organs and systems such as Irritable Bowel Syndrome and Fibromyalgia. The urologist is the specialist who can help identify the right treatment to find relief from this disabling condition ”.
Francesca Neri breaks the silence on the disease: “I thought about suicide”
What are the causes of CI?
“The causes of interstitial cystitis are still not entirely clear. Among the hypothesized causes are a defect in the bladder tissue that weakens the inner lining, the presence of specific inflammatory cells (mast cells) in the bladder, changes in the nerve endings that generate abnormal bladder symptoms, as well as an attack of the bladder by the bladder. immune system”.
How is it different from cystitis?
“IC is frequently confused with cystitis, but it is characterized by the absence of infection in the urine. If a patient has the typical symptoms of interstitial cystitis, the urinalysis does not show abnormalities such as bacteria and blood in the urine. It is true, however, that a history of recurrent cystitis appearing at a young age (20 years) can favor the subsequent appearance of chronic inflammation and neurogenic pain, which determine interstitial cystitis which then appears between the ages of 35 and 55. . In men, interstitial cystitis is often confused with chronic prostatitis “.
Which subjects does it affect and at what age?
“It affects women more frequently with a double or triple frequency compared to men. The average age of onset is between 30 and 40 years “.
How can interstitial cystitis evolve and what repercussions does it have on the quality of life of those who suffer from it?
“Interstitial cystitis hinders the social life and the working life of the patient for its emotional aspects, for the impact on marital and family relationships, as well as for the effects on physical exercise and sleep. There is no evidence that stress causes interstitial cystitis, but it is known that physical and mental stress can worsen symptoms ”.
How is it diagnosed?
“There is no medical examination that indicates whether a person has interstitial cystitis or not. To make a diagnosis, you need to evaluate the symptoms and then rule out other health problems that could be causing the same symptoms. It is necessary to focus on symptoms and their duration, on the impact of symptoms on quality of life, on the presence of other health problems and on the intake of any medications. If a patient has symptoms typical of interstitial cystitis and the urinalysis does not show infection or presence of blood, a urodynamic test that evaluates the capacity of the bladder, and a cystoscopic examination that displays any ulcerations in the bladder are necessary for the diagnosis “.
How is it treated? What are the treatment options?
“The goal of treatment is to control symptoms. Improvements in symptoms take time, and it may take months for symptoms to improve. Often the disease goes into remission but does not heal. Being a multifactorial disease, the treatment must also be multimodal and also include other coexisting pathologies. The first treatment is lifestyle change, limiting emotional stress and some irritating foods such as chocolate, coffee, alcoholic beverages and spicy foods. There are drugs in both oral and intravesical formulations, to be inserted with a catheter. These include oral antidepressants and antihistamines, as well as glycosaminoglycans and heparin to be administered into the bladder. Often the therapeutic response is insufficient and it is necessary to proceed with injections of botulinum toxin into the bladder, or to apply a bladder neuromodulator for the management of bladder irritative symptoms and pain. Bladder enlargement or replacement surgery remains the last resort, even if difficult to accept due to the serious impairment of the quality of life “.
Photo by Prof. Rocco Damiano, Full Professor of Urology at the Magna Graecia Catanzaro University
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