Bladder Pains – Painful Bladder Syndrome

Painful bladder syndrome, which includes interstitial cystitis is a group of symptoms, including mild to severe bladder pain and a sense or feeling of urgent and/or frequent need to urinate. The disorder is more common in women and is a recognized cause of Pelvi Pain Problems. It can be difficult to diagnose and treat because of misleading symptoms which is often suggestive of a gynaecological pelvic cause.

Painful bladder syndrome — PBS is defined as a group of symptoms that include bladder pain and a frequent and/or urgent need to urinate during the day and/or night. Interstitial cystitis — IC is the diagnosis used to describe people who have symptoms of PBS, as well as changes in the bladder lining (seen during cystoscopy – camera view)

Causes

Not much is known about the cause of these conditions. For example, patients with interstitial cystitis have abnormalities in the lining of the bladder. However, it is not known if these bladder abnormalities are the cause of symptoms or if the abnormalities develop as a result of some unknown underlying disorder that also causes painful bladder symptoms.

It is likely that the nerves in the bladder become highly sensitive to pain and pressure as these painful bladder conditions develop. Nerves outside the bladder, including nerves of the abdomen, pelvis, and hips, and legs, may also become more sensitive.

Events that may preceed painful bladder syndrome include urinary tract infection, an episode of vaginitis (infection of the vagina), bladder, pelvic, back, or other type of surgery and trauma (eg, fall onto the tailbone [coccyx] or car accident). However, in many people, there is no clear explanation.

Symptoms

The symptoms of PBS can vary from one person to another and from one episode to another. All patients with PBS have bladder pain that is relieved at least partially by urinating. Symptoms usually include a frequent and urgent need to urinate during the day and/or night. Most, although not all, people with PBS do not have urinary leakage (incontinence). There is often pain in the suprapubic area (in the lower abdomen, above the pubic bone) or urethral area. The pain may be one-sided lower abdominal pain or low back pain, and the severity of pain ranges from mild burning to severe and debilitating pelvic pain. Most people describe symptoms that begin gradually, with worsening discomfort, urgency, and frequency over a period of months. In some patients, symptoms are severe from the onset. There may be other conditions associated with chronic pelvic pain, such as such as irritable bowel syndrome, painful menstrual periods, endometriosis, vulvar pain (vulvodynia), or fibromyalgia.

Symptoms vary from one day to the next and may be debilitating, being associated with sleep disturbances and waking up urgently at night several times to pass urine. Worsening of symptoms may occur after consuming certain foods or drinks (eg, strawberries, oranges, beer, coffee), during the sec ond half (luteal phase) of the menstrual cycle, during stressful times, or after activities such as exercise, sexual intercourse, or being seated for long periods of time (eg, during a plane trip).

For further information  on diagnosis and treatment, see under Bladder Problems –