Bladder Pain Syndrome

doi:10.1017/9781108877084.010

Chapter 9 - Bladder Pain Syndrome

Published online by Cambridge University Press: 08 March 2021

Katherine de Souza and

Charles Butrick

Edited by

Michael Hibner

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Michael Hibner: Affiliation:
St Joseph’s Hospital & Medical Center, Phoenix, AZ

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Summary

Interstitial cystitis/bladder pain syndrome (IC/BPS) is one of the evil quadruplets – diseases coexisting with endometriosis. Etiology and even the way to obtain proper diagnosis is very debatable among providers. One of the mainstays of IC/BPS is pain with full bladder, and patients with this condition urinate often because they want to avoid pain and not because they have urgency. They also always wake up at night to urinate, so if patients do not have nocturia it almost always rules out the disease. Diagnosis of IC/BPS may be done based on the symptoms but some practitioners would use potassium sensitivity test or cystoscopy with bladder hydrodistension if necessary. Treatment consists of avoiding foods that irritate the bladder and increase the pain. Oral medications such as pentosan polysulfate sodium do not seem to be as effective. Patients with IC/BPS also very often have pelvic floor muscle spasm that may be primary to the onset of bladder pain, and treatment of this spasm may be the most effective way to treat IC/BPS. Pelvic floor physical therapy and botulinum toxin A injections to pelvic floor muscles (not bladder) may be very helpful. Cystoscopy with bladder hydrodistension seems to be more effective than other treatments for IC/BPS.

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Type: Chapter
Information: Management of Chronic Pelvic Pain
A Practical Manual
, pp. 98 - 111

DOI: https://doi.org/10.1017/9781108877084.010 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2021

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