Interstitial Cystitis (bladder pain syndrome)

Interstitial Cystitis, Tower urology of Los angeles

What is interstitial cystitis? 

Interstitial cystitis (IC), also known as bladder pain syndrome and painful bladder syndrome, is a chronic condition that causes discomfort or pain in the bladder and pelvic region. It is often accompanied by a frequent and urgent need to urinate.

IC is a complex condition that can significantly impact daily life. While it’s more common in women, men can also be affected.

Interstitial Cystitis (bladder pain syndrome)

What causes interstitial cystitis? 

The exact cause of IC isn’t fully understood. However, known causes include a defect in the bladder lining, an abnormal immune response, nerve dysfunction, Hunner or other types of bladder ulcers, or even a history of bladder and urinary tract infections.

Who is at higher risk of interstitial cystitis? 

Certain factors seem to increase the chance of suffering from this condition, including:

What are the symptoms of interstitial cystitis?

There are numerous common symptoms of IC. These include:

These symptoms can vary in severity and may flare up when you are under greater stress than usual or after consuming certain foods or drinks.

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How do we diagnose interstitial cystitis? 

Urine Test Sample

Diagnosing IC can be challenging because there’s no single test. Instead, we rule out other conditions by performing various procedures, such as taking a complete medical history, conducting physical exams, and sometimes even procedures like a cystoscopy or bladder distension.

Treatment for interstitial cystitis 

While there’s no cure for IC, many ways exist to manage your symptoms and improve your quality of life. We always create a personalized treatment plan for each patient. We’ll work together to find the approach that works best for you, helping you feel better.

There are numerous treatment options available. They include:

Lifestyle changes

One crucial change is to avoid bladder irritants, such as caffeine, acidic foods, alcohol, and spicy foods. Another is to incorporate stress management techniques.

Medications

These can include oral drugs like amitriptyline or bladder instillations, which can help reduce pain and inflammation.

Physical therapy 

Working with physical therapists on exercises that focus on the pelvic floor can also be very helpful,

Nerve stimulation techniques

Nerve stimulation techniques include sacral neuromodulation (SNM). In this therapy, a small device is implanted that sends mild electrical pulses to the nerves near the sacrum (lower back). The pulses help control bladder, bowel, and pelvic floor functions.

The device works like a pacemaker for the bladder and bowel, helping to restore regular communication between the brain and the pelvic organs. This improves symptoms of bladder or bowel control problems.

Surgery

Urinary diversion or bladder augmentation surgeries may be considered for our patients with the most severe symptoms.

What should you expect during your initial consultation with Tower Urology?

When you come in, you can expect the healthcare providers at Tower Urology to take a detailed history, including what your symptoms are, what other medical conditions you have, which treatments you’ve tried so far, and what your dietary habits are like.

We will then perform a physical exam to assess any pelvic floor dysfunction as a possible contributing factor, and also perform a cystoscopy. In a cystoscopy, a small flexible camera is inserted into your bladder to look for ulcers that may be causing you pain.

What is the Tower Urology treatment plan?

We tailor the treatment plan to your specific needs, based on the findings from your workup. For example:

If you have pelvic floor dysfunction 

We will discuss pelvic floor physical therapy or injections into the painful muscles to help relieve the spasms that cause pain

If you have painful bladder ulcers 

We will encourage them to facilitate their healing. In this procedure, we use a high-frequency electric current to destroy the ulcer. Then, we will administer an effective medication called cyclosporine to help prevent the ulcers from reforming.

If we don’t find pelvic floor dysfunction, ulcers, or another apparent cause for your pain 

Then, we will work together to develop a treatment plan to manage your symptoms. This plan could include hydrodistension, bladder instillations with medications, oral medications, and dietary modifications.

In the most severe cases 

We may recommend removing the bladder, although this is something we always strive to avoid.

Why Tower Urology is your best choice in Los Angeles for interstitial cystitis doctors near you

Controlling IC/BPS symptoms can be a process, so it’s important to establish care with a provider who will continue to work with you to find the solution that is right for you individually. Fortunately, the urologists at Tower Urology are experts in treating this condition and are always willing to help.‌

The main advantage of Tower Urology lies in our unwavering commitment to providing world-class urologic care through advanced technology, personalized treatment plans, and a patient-centered approach. With a reputation for excellence and innovation, we deliver superior outcomes that distinguish us as leaders in urologic health.

Tower Urology is a proud affiliate of Cedars-Sinai Medical Center, ranked #1 in California and #2 nationwide by U.S. News & World Report. This partnership reflects our dedication to delivering the highest standard of urologic care alongside the best urologists in Los Angeles. Our years of experience and access to Cedars-Sinai’s world-class facilities ensure that our exceptional and innovative urological care positions Tower Urology as a leader in Southern California.

We invite you to establish care with Tower Urology.

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Tower Urology is conveniently located for patients throughout Southern California and the Los Angeles area, including Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, and Downtown Los Angeles.

Our services include treatment for pelvic organ prolapse, menopause/hormone management, chronic pelvic pain syndrome in women, shockwave therapy for pelvic pain, interstitial cystitis, lichen sclerosis and planus, urethral diverticulum, urethral stricture disease, urinary fistulas, and vaginal mesh complications.


Interstitial cystitis FAQs

Which specialist is consulted for cystitis? close-icon

Primary care physicians typically evaluate cystitis first, after which patients may be referred to specialists, including urologists, urogynecologists, or nephrologists.

Patients may be referred to specialized centers with multidisciplinary teams, such as Tower Urology, for interstitial cystitis or complex bladder issues. These teams include urologists, surgeons, physical therapists, and lab technicians.

Do you believe that pelvic floor muscles can cause IC symptoms? close-icon

Absolutely. Pelvic floor dysfunction can mimic interstitial cystitis (IC) symptoms, as tight pelvic floor muscles can put pressure on the bladder, causing spasms that lead to urgency, frequency, and pain.

Research shows that 87% of women with IC have pelvic floor dysfunction with levator muscle pain, suggesting a strong connection between these conditions. The symptoms can be so similar that what appears to be IC might be pelvic floor issues, and many patients receive IC diagnoses without proper bladder scoping to confirm the presence of characteristic lesions.

Treatment often involves a multimodal approach, including pelvic floor physical therapy, muscle lengthening techniques, and lifestyle modifications, regardless of whether the root cause is IC or pelvic floor dysfunction.

Is neuromodulation safe or dangerous? close-icon

Sacral neuromodulation (SNM) is generally safe but comes with potential risks and complications that patients should consider. The therapy has been proven effective for over 20 years, with success rates showing symptom reduction in 67% of patients even after five years.

Education Team

Written by Tower Urology's Education Team

The Tower Urology Education Team is a collaborative group of physicians, surgeons, and medical writers dedicated to providing accurate, accessible, and expert-reviewed information on urologic health. Our goal is to empower patients with trusted resources that reflect the clinical excellence of Tower Urology in Los Angeles.

Paige Kuhlmann

Medically Reviewed by Paige Kuhlmann, MD

Dr. Paige Kuhlmann, MD, is a fellowship-trained urologist specializing in female pelvic medicine, reconstructive surgery, and sexual health. She completed her urology residency at Cedars-Sinai and a subspecialty fellowship at UT Southwestern. At Tower Urology, she leads women’s sexual health services while providing advanced care for complex pelvic and urologic conditions.

What patients say about Tower Urology

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Over 346 Reviews

Dr Josephson has a magic hand. after protate surgery usually most of the patients get leaks but mine was perfect. He is very intelligent, helpful, patient, and polite. I recommend him to all my friends and family

SHAWN M.
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Dr Justin Houman has made a positive impact on my health. At first I was nervous about seeing a Urologist but he made me feel comfortable to open up and solve my problems. Highly recommend him. Five Stars ⭐️

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Baguette M.

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Dreamland D.
Dreamland D.

I have been suffering from Testicular pain for the past 3.2 years, and it has been a challenging journey. If I do certain activities like long walks, lifting weights and sex triggers or worsen my testicular pain. The pain was intense enough to significantly impact my daily activities. Pain forces me to rest for 1 to 2 days and applying the Ice packs frequently. I finally met Dr. Justin Houman, who has truly been my life saver. I recently underwent Microsurgical Spermatic Cord Denervation and Varicocelectomies Surgery with Dr. Justice Houman and I noticed a significant reduction in my chronic testicular pain, which has greatly improved my quality of life. I have gradually resumed activities like long walks, lifting weights, sexual activity and I am experiencing only very minimal testicular pain, which doesn’t affect my daily activities. I would highly recommend Dr. Justice Houman to anyone suffering from chronic testicular pain, he is a true expert in men’s andrology. Dr. Houman is truly a life saver for me, Thank you very much Dr. Houman!

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Dr.Josephson was an Answer to many prayers! I recently had surgery in Bakersfield with urologist who is past his prime. I couldn't get help after my TURP surgery. For 3 months (90 days) I was in great discomfort, unable to urinate without extreme pain. 40 times a day,wanting to cry ! My Bakersfield urologist said there was NOTHING he could do to help me. A friend sent me to Dr. Josephine. I prayed for a miracle and Dr. Josephson kindly obliged. No further surgery was needed! Dr.Josephson took the "time" to examine me and found the issue immediately and I left his office as happy a child !! Thank you,Dr.Josephson, words cannot express my gratitude enough!! You helped me greatly in my time of need! You were kind and gentle and made me feel cared for. Thank you,May God Bless You !! JSM

John M.
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I had a wonderful experience with Dr. Kuhlmann and her team. Her bedside manner was fantastic and put me at ease throughout my visits. She was responsive to my questions and fully explained my treatment plan. My quality of life has significantly improved and I am so thankful to have found a physician I can trust. Would 100% recommend.

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Jacqueline R.

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Sarineh Y.
Sarineh Y.

Very pleasant, helpful, and very knowledgeable doesn’t do any test, which is not necessary like most of the other Urologist do give you a clear opinion of your health and give you good advice I strongly recommend him I do wish him all the best in his career

David N.
David N.

A family member was struggling with testicular pain for years and had concerns about fertility. I am so grateful that we were referred to Dr. Houman. He is very thoughtful and knowledgeable and has great bedside manner. He diagnosed a varicocele and recommended microsurgical varicocelectomy and we are so happy with the results. I highly recommend Dr. Houman.

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Amazing urologist. Go to expert for men’s health. I refer patients to him as often as possible!

Ilan K.
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The best. I can’t say enough good things about the care i received and continue to receive from all the people at Tower urology especially Dr. Joesepson.

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Amir Y.
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How did a woman with a lifetime of recurrent bladder infections wind up with a urologist whose specialty is male fertility? It happened like this...Dr. Houman was recommended to my husband when he began having the prostate problems that can devastate older men. Dr. Houman solved his urinary difficulties, and I'm convinced, kept him from the fate of a constant catheter. Naturally, I jumped at the chance to be his patient, and have been, for the first time in my life, free for several months of any infections. But the best part of being Dr. Houman's patient is this. When you are in trouble, he will keep in constant touch with you...he does not isolate himself behind a wall of nurses. Naturally, I recommend him highly, Marilyn B.

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My experience with Dr. Houman has been nothing but positive. He takes the time to really listen and provide solutions. I came to him, very unsure and very unhappy, with a procedure done by another doctor several years earlier. After a couple of meetings Dr. Houman assured me that he could help me. And that’s exactly what happened. I'm very pleased with the results. His bedside manner and can-do attitude, his insight, enthusiasm and quick email responses were greatly appreciated. You can’t do better than Dr. Houman. I highly recommend him.

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spicy G.
spicy G.

Best doctor in town!

Hannah N.
Hannah N.

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martha F.

Dr. Houman is an outstanding urologist. He’s professional, knowledgeable, and kind. He really took the time to thoroughly answer all my questions. I would highly recommend Dr. Houman.

Ashley H.
Ashley H.

Dr Houman is the urologist you’ve been looking for! He never shies away from a challenge and has taken excellent care of me over many hurdles! He’s dedicated to each patient, never in a rush and a talented surgeon!!

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Thomas C.

Dr. Kuhlmann is a fantastic urologist — she really takes the time to listen and address your concerns. I couldn’t recommend her enough

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Dr. Houman was the most compassionate and caring doctor that we met in our 10 day stay at the hospital. He is a knowledgeable doctor that genuinely wants to help.

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Dr. Kuhlmann is extremely knowledgeable and a truly caring physician. She has a way of communicating confidence and expertise while also meeting each of her patients on their level. Very professional and goes the extra mile for everyone she cares for.

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Samuel G.

Dr. Houman was amazing, don’t typically do reviews but he was extremely thoughtful and helpful. Highly recommend!

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Janet N.
Janet N.

Dr. Houman is the BEST! He literally saved my grandpa's life and he couldn't be more kind and thoughtful. If Dr.Houman is your doctor then you're in amazing hands! Thank you Dr.Houman

Ella N.
Ella N.

Dr Kuhlmann is a fantastic physician. She is very caring and attentive. I appreciate her dedication.

Danielle B.
Danielle B.

When my patient’s need a urologist, I go to Dr. Kuhlmann. She is my top choice for urologic care in the region. Desmond Huynh, MD

Desmond H.
Desmond H.

Excellent physician and great listener. Most physicians don’t take the time to understand or put themselves in their patient’s shoes. Dr. Kuhlmann is the opposite of that. Highly recommend.

Joleen H.
Joleen H.

Dr. Paige Kuhlmann is a warm, caring, compassionate and smart doctor. She went out of her way to accommodate my mom and made her feel so comfortable. I give her a 10 out of 10!

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Wendy F.

Extremely knowledgable and informative.

Leslie M.
Leslie M.

She was very knowledgeable and answered all my questions. Highly recommend!

Patrick P.
Patrick P.

I usually do not write reviews however Dr Houman is an exception. He is a terrific urologist and very knowledgeable. What might be equally important is his care and attention, quickly returning emails as well as phone calls. In an age of increasing fast in fast out medical care, Dr Houman works with a personal touch rarely seen these days. I highly recommend him.

Richard K.
Richard K.

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