About 5% of IC patients have symptoms for more than 2 years and 5% of patients have end stage disease defined as very hard bladders with low capacity and terrible pain. Many have Hunner's ulcer. Kristene Whitmore, MD, from the Pelvic and Sexual Health Institute (PSHI), discusses how to treat severe IC. Dr. Whitmore was interviewed at the joint meeting of the International Continence Society and the International Urogynecological Association in Toronto by the Interstitial Cystitis Association (ICA). Dr. Whitmore is a member of the ICA Medical Advisory Board.