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Painful Bladder Syndrome

What Is Painful Bladder Syndrome?

Painful Bladder Syndrome, Bladder Pain Syndrome (BPS), and also Interstitial Cystitis (IC), is a chronic condition that causes feelings of pressure or pain to the bladder and increased need to urinate. In some cases, it can cause severe pelvic pain.

What Are The Causes Of Painful Bladder Syndrome?

The precise cause of interstitial cystitis is not known, but many cases are contributed to by a break in the bladder’s protective lining (known as the epithelium) which allows harmful substances found in urine to leak through and cause irritation to the wall of the bladder. IC may also be caused by a faulty nervous system response which sends pain signals to the brain for functions which are not ordinarily painful. You may be more likely to have painful bladder syndrome if it has affected another member of your family, and you could also be at a higher risk if you have recently suffered an infection of the bladder.

Men With Interstitial Cystitis

Men can get interstitial cystitis (IC) or painful bladder syndrome. Common symptoms of IC and BPS are urinary urgency, urinary frequency, nocturia (getting up at night to go to the bathroom), suprapubic or pelvic pain, the pain classically worsens with bladder filling and is relieved with urination, dysuria (burning with urination), and the sensation of incomplete evacuation of urine. If IC/BPS are present for many months or even years symptoms of pelvic pain and pelvic floor muscle spasm are seen. These include rectal spasms or rectal pain, pain with erection or ejaculation, soreness post erection or ejaculation, pain at the tip of the penis, groin or testes, prostate, bladder, epididymis, and testes tenderness. Treating the associated pelvic pain and pelvic floor spasm can help with symptoms of IC and BPS.

What Are The Signs And Symptoms Of Interstitial Cystitis?

Painful Bladder Syndrome InformationSymptoms of painful bladder syndrome may vary in type and severity depending on the person and the situation, with some people experiencing more painful flare-ups due to factors such as menstrual cycle, emotional stress, or sitting for a long period of time. Some of the most common symptoms include:

  • Urge to urinate which may not go away after voiding the bladder
  • Urinating an unusually high number of times throughout the day, usually very small amounts with each trip to the bathroom
  • Urinating in the middle of the night
  • Burning with urination
  • Chronic pelvic pain
  • Pain between the anus and genitals
  • Pain with sexual intercourse

How Do You Know If You Have IC?

IC can be diagnosed with a proper history and physical from a urologist. It is first important to rule out an infection. Sometimes the urologist will feel it is appropriate to do other tests regarding bladder function and to rule out other causes for the symptoms described above. One test called a cystoscopy is when a camera is placed inside your bladder. The difference between IC and painful bladder syndrome is that the cystoscopy will show Hunner’s ulcers on the bladder in IC and the cystoscopy is normal in Painful Bladder Syndrome.

What Are The Risk Factors Of Interstitial Cystitis?

Interstitial cystitis is more common in women than men, and also appears to most commonly affect people with fair skin and red hair. Age is also a factor, with most people not experiencing symptoms of painful bladder syndrome until their thirties or later. In some cases, it can also be linked to other chronic conditions like endometriosis, fibromyalgia or irritable bowel syndrome. There are currently no lifestyle factors that are known to cause interstitial cystitis.

How Is Painful Bladder Syndrome Diagnosed?

Your doctor will begin by getting a detailed description of your symptoms and medical history and performing a physical exam of the pelvic region. A urine test may be performed to rule out urinary tract infection.

A cystoscopy may be performed. A cystoscopy is a diagnostic procedure in which a slender tube with a camera is inserted through the urethra to examine the inside lining of the bladder. During this procedure, your doctor may inject liquid into the bladder to test its capacity, or remove tissue to examine for signs of bladder cancer.

What Are The Possible Treatments For Interstitial Cystitis?

Pelvic Rehabilitation Medicine values a multidisciplinary approach to pelvic pain, and can employ a combination of treatment techniques to relieve interstitial cystitis / painful bladder syndrome symptoms.

  • Physical Therapy: Pelvic floor physical therapy may help relieve muscle tightness or dysfunction that contributes to bladder pain.
  • Lifestyle Changes: Many people with interstitial cystitis find that their symptoms are exacerbated by certain foods such as caffeine, spicy foods, and refined sugars. Keeping a pain diary may help zero in on trigger foods and craft an exclusionary diet to reduce pain symptoms. Stress Management/Anxiety reduction is also an important lifestyle modification.
  • Oral Medications: Antidepressants, anti-histamines, and pentosan polysulfate sodium are all oral medications that can help treat the symptoms of IC.
  • Bladder Instillations: Also known as a bladder wash or bladder bath, this procedure involves introduction of a medical solution directly into the bladder to relieve symptoms
  • Surgery: Invasive treatment of interstitial cystitis is a last resort, used only if other, less extreme measures are ineffective. Surgery can be performed to remove ulcers or increase the bladder’s capacity.

Are There Preventative Steps Or Measures To Avoid Painful Bladder Syndrome?

There are no known measures to prevent the onset of painful bladder syndrome, but symptoms can often be managed by avoiding foods or activities which have been observed to increase the severity of pain symptoms.

What Are The Risks If Interstitial Cystitis Is Left Untreated?

If left untreated, bladder pain syndrome may cause the wall of the bladder to stiffen, causing a long-term decrease in bladder capacity. Pain with intercourse can negatively impact your sex life and romantic relationships, and pain and frequent need to urinate can cause major disruptions in your sleep schedule and everyday routine.

Are There Other Related Conditions To Painful Bladder Syndrome?

Other conditions, such as endometriosis, fibromyalgia and irritable bowel syndrome, may contribute to interstitial cystitis. There are also some conditions, such as urinary tract infection and prostatitis, which may cause frequent urination and bladder pain.

Key Takeaways

Painful Bladder Syndrome is a chronic condition that causes feelings of bladder pressure and pain, as well as pelvic pain and a frequent need to urinate. Its cause is not known, but heredity, sex, and age are all potential risk factors. While there is no known cure for interstitial cystitis, its symptoms can often be treated through pelvic floor physical therapy, lifestyle changes, and anti-inflammatory medications.
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Meet Pelvic Rehabilitation Medicine

At Pelvic Rehabilitation Medicine, we treat whole human beings, not symptoms. In the body, everything is connected; and the pelvic region is the vital center of the body’s connected functioning. Our physicians take an innovative approach, combining traditional medicine with holistic modalities and rehabilitative medicine. We treat both male and female patients who experience core muscle and nerve problems; chronic pelvic pain; and pelvic floor muscle dysfunction. Learn More »

Norman J. Marcus, MD Allyson Augusta Shrikhande, MD Bill McCarberg, MD Edward Gracely, PhD. A Preliminary Study to Determine if a Muscle Pain Protocol Can Produce Long-Term Relief in Chronic Back Pain Patients. Pain Medicine. 2013 Aug; 14(8): 1212–1221. Link to Article.

Allyson Augusta Shrikhande, MD. Interviewee on Pelvic Health Summit - CPPS. Pelvic Health Summit. 2018 May. Link to Interview.

Allyson Shrikhande, MD sits as the chair of the Medical Education Committee for the International Pelvic Pain Society. Link to Medical Committee.

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