Painful Bladder Syndrome

The bladder is a hollow organ that stores urine. Once the bladder expands to full capacity, it sends a message to the brain through the pelvic nerves that it’s time to urinate. This message produces the urge to use the restroom.

When the brain confuses these messages, a condition called interstitial cystitis, or painful bladder syndrome, can develop. This is a chronic condition that can cause severe pain and have a major effect on long-term quality of life.

Symptoms and Complications

Symptoms of interstitial cystitis vary between cases and aren’t always the same over time—they often flare up, sometimes in response to triggers (e.g., stress, exercise, sexual activity or menstruation). Symptoms can include:

• Pain: Women may feel pain in the pelvis between the vagina and anus, and men may feel pain between the scrotum and the anus.
• Urges: You’ll notice a frequent need to urinate, even when you’ve done so recently
• Pain during sex (for women), or during orgasm or after sex (for men)
• Frequent urination, often in very small amounts
• Pain that continually gets worse as the bladder is filling, then goes away after urination
• Stinging or burning feelings during urination
• Inflamed bladder
• Ulcers in the bladder (in about 5 to 10 percent of cases)

A few complications are associated with painful bladder syndrome:

• Poor quality of life: Regular urination can interfere with basic social life, as well as work or school responsibilities.
• Lowered bladder capacity: Interstitial cystitis can cause the bladder wall to stiffen, meaning it can’t hold as much urine.
• Emotional health problems: Chronic pain and sleep issues resulting from painful bladder syndrome can lead to emotional stress and depression.
• Difficulty with sexual intimacy: Personal relationships, including sexual intimacy, can be damaged due to the effects of frequent urination.

Causes and Risk Factors

There aren’t any exact known causes of interstitial cystitis, though issues with the lining of the bladder may be associated with many cases. It’s possible factors like heredity, infections, allergies or an autoimmune reaction might also contribute, though this has not been proven.

There are a few factors associated with increased risk:

• Age: Most diagnoses occur in people over the age of 30.
• Gender: Women are at high risk.
• Skin or hair color: Fair skin and red hair have shown association to a higher risk of painful bladder syndrome.
• Chronic pain disorder: Conditions like irritable bowel syndrome and fibromyalgia are associated with interstitial cystitis.

Treatment

A few different tests might help identify interstitial cystitis, which has symptoms that mimic other urinary tract conditions. If a test results are positive, there are a wide range of treatment options:

• Physical therapy: Physical therapy can help relieve muscle tension and pelvic pain.
• Oral medications: Certain medications Including anti-inflammatory drugs, antidepressants, antihistamines and polysulfate sodium can be beneficial.
• Nerve stimulation: Nerve stimulation uses electrical stimulation to help reduce urinary frequency and strengthen muscles that control the bladder. In some cases, this will include a permanent implant similar to a pacemaker in the heart.
• Bladder distention: This is a procedure using water to stretch the bladder.
• Medication instillation: A process where medication is run through a catheter into the urethra.
• Surgery: A rare treatment, but one that’s used to remove ulcers or increase bladder capacity.
• Alternative medicine: Both guided imagery and acupuncture have shown some success in treating painful bladder syndrome.

There is no single treatment that will always eliminate symptoms, and many people have to use a combination of treatments to reduce symptoms as much as possible.

Increasing Comfort

Basic strategies that may reduce discomfort and other symptoms include:

• Bladder training: This involves timing urination and learning to control urinary urges through relaxation
• Dietary changes: Reducing intake of foods that fall into the “four Cs” category—carbonated drinks, caffeine, citrus and vitamin C—can help relieve discomfort from interstitial cystitis
• Stress reduction
• Wearing loose clothing: This take pressure off the abdomen
• Simple stretching exercises
• Quitting smoking

If you’re showing signs of painful bladder syndrome, speak to your doctor about your diagnosis and treatment options.

Revere Health Urology specializes in the diagnosis and treatment of urologic cancers, BPH, incontinence and vasectomies as well as pediatric and adult urinary problems.

Sources:

“Interstitial Cystitis.” WebMD. http://www.webmd.com/urinary-incontinence-oab/interstitial-cystitis#1

“Interstitial cystitis.” The Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/interstitial-cystitis/home/ovc-20251830