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Test and Procedures

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  • Test and Procedures

    Hope this helps: Just scroll down until you find the test you are looking for.



    The cystoscope, is a long thin telescope like instrument fitted with two channels. The first channel consists of a lens and a fibro-optic light source and the second channel allows fluids to be instilled into your bladder. The cystoscope is small enough (approx. the size of a straw) to be inserted through the urethra into the bladder.

    The cystoscopy, enables the urologist to look into the bladder and observe it's general condition to see if there are any signs of abnormalities and to check the neck of the bladder as well the positioning of the uterers. The cystoscopy also enables, the urologist to see if any type of prostate obstruction is present due to prostate enlargement.


    Bladder distention, is one of the most essential tests for the diagnosis of Interstitial Cystitis. Because the bladder distention is painful in IC patients, and if IC is suggested, this procedure is normally done under general anesthesia.

    This procedure consists of, distending the bladder or stretching the bladder to it's full capacity, by instilling gas or liquids through the cystoscope. This test can detect inflammation, a thick, stiff bladder wall, Hunners ulcers, and glomerulations (pinpoint bleeding) that may be seen only after the bladder is stretched.

    The doctor may also test the patient's maximum bladder capacity, the amount of liquid or gas the bladder can hold under anesthesia. Without anesthesia, capacity is limited by either pain or severe urge to urinate. Many people with IC have normal or large bladder capacities under general anesthesia. However, a small bladder capacity under anesthesia helps support the diagnosis of IC.



    (1) Patient is administered local anesthesia
    (2) The bladder is filled and distended with gas or liquid
    (3) Once the bladder is distended the gas or liquids are released. This allows sufficient
    viewing of glomerulations or Ulcers as well as inflammation.

    Diagnostic Hydrodistention:

    (1) irrigation fluid is pumped into the bladder, usually 80-100cm above the patients bladder capacity.
    (2) the irrigation fluid is pumped into the bladder until it comes to a drip, this is when the bladder is filled to capacity.
    (3) pressure is applied to the urethra by pressing in the anterior vaginal wall. This is done to prevent leaking so a accurate volume of fluids can be taken.
    (4) the bladder is observed for possible rupture, although this is very rare.
    (5) the fluids are held for one or two minutes, the bladder is emptied, and the contents
    of fluids are measured
    (6) the fluid is of clear color, then becomes blood tinged when the last 50-100cc of fluid is released (the bladder capacity is lowered in the classic/ulcerative IC and normal in the non-ulcerative IC
    (7) the bladder is than viewed again in the distended state
    (8) A second therapeutic distention may also be required
    (9) the bladder is distended again and held for approx. 8 to 10 minutes
    (10) Biopsies may be taken, usually from two separate spots of the bladder
    (11) catheter is usually placed (if deep biopsy is performed)
    (12) the procedure is complete

    reference: Denise A. Nigro, Alan J Wein., Interstitial Cystitis: Grannum R. Sant: chap17;139-140


    A biopsy is a microscopic examination of tissue. Bladder biopsy, is performed with a cystocopy, and a long tweezer-like instrument which is attached to the cystoscope. Small samples of tissue are removed from different locations of the bladder wall and the urethra.

    Biopsy is always done after hydrodistention, The biopsy has no pathognomonic findings for IC, (biopsies can not determine IC) they are done to rule out other varieties of cystitis or conditions, i.e., malignant or premalignant diseases.

    Reference: ICN patients Handbook

    (The Parsons Test)

    This simple test , developed by Dr. C. Lowell Parsons to measure epithelial permeability, is based on the hypothesis that a solution of KCI (potassium) will produce no symptoms of urgency or pain when places in a normal bladder. However, there will be symptoms of urgency or pain if such solution is placed in an impaired bladder.

    The test is performed, by instilling two solutions into the bladder for 3 minutes each. Solution #1 is sterile water while solution #2 should contain 40 mEq of KCI in 100 mL of water.

    After the solution is instilled, the patient will be asked "To what extent does it provoke your symptoms on a scale of 1 (low) to 5 (high). If the patient has no response to water, but states that KCI solution is causing symptoms to increase by two or more pain levels, this is considered a positive test.

    Reference: Alza Canada Inc., Potassium Test Protocol (informational brochure)


    Urinalysis and Urine Culture

    These tests can detect and identify the most common organisms in the urine that may be causing symptoms. There are, however, organisms such as the bacteria chlamydia that can't be detected with these tests, so a negative culture does not rule out all types of infection. A urine sample is obtained either by catheterization or by the "clean catch" method.

    White and red blood cells and bacteria in the urine may indicate an infection of the urinary tract, which can be treated with an antibiotic. The choice of drug and length of time of treatment depends on the offending bacteria.

    The sensitivity test is especially useful in determining the most useful antibiotic, in which the bacteria is susceptible to. This test normal takes approx. 5 days to get a accurate result.

    If urine is sterile for weeks or months while symptoms persist, a doctor may consider a diagnosis of IC.


    For a "clean catch," the patient washes the genital area before collecting urine "midstream" in a sterile container.


    In men, the doctor will obtain prostatic fluid from the patient. This fluid will be examined for signs of an infection, which can be treated with antibiotics. The Prostatitis Foundation offers extensive material on prostate massage, culturing and new diagnostic techniques. Additional information can be obtained by mailing or calling the following address:

    Prostatitis Foundation
    1063 30th Street Box 8
    Smithshire, Illinois 61478
    fax 309-325-7184
    voice mail 1-888-891-4200


    The Urologist inserts his finger into the rectum and with slight pressure, he presses against the prostate. At this point you will be asked to cough, and the prostate fluid will be collected and placed on a slide for examination.

    (Intravenous Pyelogram)

    The IVP, is an x-ray examination performed with a intravenous contrast (iodine dye) injection, which is injected into the veins. The contrast which is concentrated by the kidney, outlines the ureters, bladder and kidneys upon x-ray examination.

    The purpose of this test is evaluate the function and structure of the kidneys, ureters and bladder.


    Patient preparation prior to this test is normally required. The preparation of this test includes a process to clear the colon. The most common procedure (preparation may vary as per prescribing physician) This is normally done by taking (4) - 5mg Dulcolax tablets the evening prior to testing.

    Nothing should be taken by mouth after 12:00 midnight, the night before the procedure.

    (1) you will be positioned on the X-ray table
    (2) preliminary X-rays will be taken
    (3) the intravenous line will be administered and the contrast injected
    (4) a sequence of x-rays will be taken
    (5) this test normally can take from 15 minutes - 90 minutes determining on the
    doctors prescribing directions.


    (Voiding Cystourethrogram)

    A cystogram (VCUG), is a diagnostic x-ray examination of the bladder and urethra using a liquid contrast material which is instilled directly into the bladder through a catheter.

    The Cystogram enables the physician in detecting abnormalities of the urethra and the bladder. This test also can help determine abnormal voiding. In males this tests can detect if there is narrowing of the prostatic urethra and detect urethral stricture in both male and female.


    (1) A catheter will be inserted into the urethra and passed through the bladder
    (2) the contrast solution will be instilled into your bladder through the catheter and the
    catheter will be clamped so the contrast stays with-in your bladder
    (3) x-rays will be taken in various positions
    (4) The catheter is now removed and x-rays are taken while your bladder is emptying (you will void on a special toilet)
    (5) Once your bladder is emptied, a final X-ray will be taken.

    References: http://www.phepegypt.silverplatter.c...on/A210320.htm

    (Nuclear Bladder Scan)

    A Radionuclide Cystogram is a diagnostic scanning x-ray examination of the bladder and urethra using radio active materials (liquids) which is instilled directly into the bladder through a catheter.

    The Radionuclide Cystogram is performed to evaluate the filling and emptying of the bladder along with evaluation of reflux of urine and obstruction to the flow of urine.


    (1) A catheter will be inserted into the urethra and passed through the bladder
    (2) the radioactive liquid will be instilled into your bladder through the catheter until your bladder feels full. Catheter is removed.
    (3) The bladder is scanned full
    (4) you will be asked to empty your bladder (usually allowing you to use the restroom)
    (5) Immediately after emptying your bladder another set of scanning x-rays are taken
    allowing your bladder to be tested for incomplete bladder emptying.



    A cystometrogram is a test that allows your physician to determine the capability of the bladders compliance, capacity, stability and sensation while filling. It also enables the physician to determine the ability of the bladder to empty itself, detrusor (the smooth muscle that forms the bladder) contractability and detrusor pressure.


    (1) you will be positioned as if you were having a pelvic exam
    (2) a catheter will be placed through the urethra into your bladder
    (3) a small balloon will be inserted inside the catheter, this causes the catheter to stay in place during the procedure.
    (4) another catheter will be inserted, in the vagina or the rectum (this measures the intra-abdominal pressure) and another small balloon will be inserted into the catheter allowing the catheter to stay in place.
    (5) water is than instilled into your bladder through the catheter and you will be asked to let the technician know, (1) when you feel the water going into your bladder (2) When you feel that your bladder is full, and, (3) When you feel that your bladder is to full to tolerate.



    Electromyography is a test that is performed using a combination of electrodes. There are three different types of electrodes, the needle electrode, surface electrode (patch) and the wire electrode. Surface electrodes are sometimes used, but do not provide the best accuracy. These electrodes are placed in the perianal area.

    This test is designed to evaluate the activity of the sphincter muscle (muscle that is used to close the urethra when the urge to void is present).

    The electrical activity of the sphincter muscle is picked up by the needle electrodes onto a monitor screen or audio on special speakers.


    (1) Positioning will vary as per physicians prescribing information to the technician. You can be placed in a supine position, standing position and or sitting position. Because a majority of the sensory nerves are located at the bladders base, the positioning of sitting or standing is recommended .
    (2) A catheter will be placed in your bladder
    (4) Than the electrodes will be placed . The needle or wire electrodes are placed
    directly on the sphincter muscle, for the female, they are placed approx. 1" a frothe
    vaginal opening, and in the male, between the base of the scrotum and the rectum.
    (5) once the catheter and electrodes are placed in the proper positioning, the bladder is filled, usually with sterile water.
    (5) the electrical activity of the sphincter muscle is registered on a monitor or on
    special audio speakers.
    (6) steps 4 and 5 may be repeated


  • #2
    The information on the test was very helpful. I have had the potassium test and was told I have IC. After several medications and a pesseray, the doctor said he could no longer help me and referred me to another urologist. This doctor did the cystometrogram (not quite like you described but similar) and told me my bladder held normal amounts of fluid so I did not have IC and suggessted a hysterectomy and bladder lift. He referred me to yet another urologist because he doesn't do surgery. I am having problems finding a urologist that takes my insurance. My father died of bladder cancer and I am concerned because I feel the right tests are not being done. I have had puss in the urine without infection. Any advice on what test to ask for would be appreciated. I feel the 1st doctor was right, because diet does seem to help with the frequency, urgency, and pain. All symtoms are still there, just not as severe.