Is there a link between endometriosis and interstitial cystitis?
—KIM C. CHERRY, MSN, FNP-BC, Greenville, N.C.

Both endometriosis and interstitial cystitis are complex inflammatory conditions associated with chronic pelvic pain. In endometriosis, hormonally reactive endometrial tissue forms implants (endometriomas) in locations other than the uterine cavity. Common sites of endometriomas include the uterine cul-de-sac, peritoneal cavity, ovaries, and bladder. Interstitial cystitis, a poorly understood urologic syndrome, involves daytime and nighttime urinary frequency and urgency and bladder pain. Patients with endometriosis may also experience bladder-related pain as a result of tissue growth on or near the bladder. The pain is likely to be cyclic but may be exacerbated by a full bladder or other changes in the pelvis. This is distinct from interstitial cystitis, though the two processes may have overlapping symptoms (e.g., pain, dyspareunia) and can coexist. Independent tests should be completed for each possible diagnosis and treatment undertaken for any findings. Surgery is another possible etiologic link between endometriosis and interstitial cystitis. Patients with a history of pelvic surgery are at higher risk for the development of interstitial cystitis, and many patients with endometriosis undergo laparotomy for diagnosis or for lysis of adhesions.
—Lisa Stern, APRN