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Bladder Pain Syndrome

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Interstitial cystitis, also called bladder pain syndrome, is an ongoing condition that causes pain or pressure in your bladder or urethra. Normally, when your bladder is full, the pelvic nerves signal your brain that it's time to urinate and this gives you the urge to go to the bathroom. When you have interstitial cystitis, you feel the urge to urinate more frequently, and the amount of urine is less than usual. In addition to these symptoms, you have the sensation of significant pain either prior to urinating, during urination, or both.

People who have interstitial cystitis can have bladder inflammation (swelling) or irritation in the wall of their bladder, which may lead to bladder scarring and stiffening. This makes it harder for your bladder to expand as it fills with urine.


What are the risk factors of interstitial cystitis?

Although interstitial cystitis affects men and women, it's more common in women. It's also more common in people 30 and older. There are a number of theories as to why this condition develops, though the exact cause is still not well understood.

You may also have a higher risk of developing the condition if:

  • You are fair-skinned
  • You have another pain syndrome, such as fibromyalgia or irritable bowel syndrome

What are the symptoms of interstitial cystitis?

The symptoms of interstitial cystitis can often be confused with other pelvic conditions that cause pain, such as urinary tract infections and sexually transmitted diseases (STDs).

Symptoms may include:

  • Frequent urination day and night (up to 60 times a day in severe cases), often in small amounts
  • Pelvic pain, including pain during intercourse
  • Persistent, strong urge to urinate
  • Pain prior to, during, or after urination

At the Desai Sethi Urology Institute, we specialize in treating interstitial cystitis. No single treatment works for everyone, so our doctors draw from a wide range of the latest approaches to help you feel better. You get personal attention and treatment that’s designed just for you. You and your doctor will work together to treat this chronic condition.


Tests

Pelvic exam
This test examines your vagina, cervix, pelvic floor, and possibly your rectum. Your doctor also feels your abdomen to check for any irregularities in your internal pelvic organs.

Urine Tests
Your doctor will do lab tests to check for a urinary tract infection or other conditions that might be causing your symptoms.

Cystoscopy
Cystoscopy lets your doctor look at the inside of your bladder. The procedure uses a thin, flexible tube and viewing device inserted through your urethra. Your doctor may take a sample of tissue (biopsy) from your urinary tract or bladder during the exam to look for cancer or other diseases.

Bladder Function Test
Also called urodynamic testing, the bladder function test consists of two phases – a storage phase and an eliminate phase.


Treatments

Lifestyle Modifications
Your doctor may recommend lifestyle changes to relieve symptoms related to an overactive bladder, such as emptying your bladder on a regular schedule or avoiding tobacco and foods and beverages that irritate your bladder. Also, they may recommend you exercise and use stress management techniques, such as yoga or meditation, to improve symptoms.

Physical Therapy
Many people with interstitial cystitis have painful muscle spasms. But performing pelvic floor exercises on your own can tighten your muscles. That’s why it’s essential to work with a physical therapist to help relax the pelvic floor and improve overall pelvic floor health.

Your physical therapist may also show you how to use a transcutaneous electrical nerve stimulation (TENS) device, an external device that delivers mild electrical pulses to adhesive patches placed on the skin of your abdomen. This can improve blood flow to your bladder and relieve pain.

Medications
Medicines can help protect your bladder wall from irritation, relieve pain, relax pelvic muscles, and reduce bladder spasms. Your doctor may deliver liquid medicine directly into your bladder (bladder instillation) through your urethra using a catheter (flexible tube).

Bladder Distention
Using a cystoscope (a hollow tube with a lens), your doctor fills your bladder with fluid to stretch the walls. This can improve pain and urgency symptoms.

If your doctor sees ulcers in your bladder (Hunner’s lesions), they will treat the ulcers by burning them or using a steroid injection.

Onabotulinumtoxina
This neurotoxin helps prevent unwanted bladder contractions. In some instances, it can also help with pain. Your doctor injects the medication into your bladder.

Sacral Nerve Stimulation
This small, implanted device, similar to a heart pacemaker, can help reduce your urge to urinate and sometimes relieve pain. The device, implanted under the skin of your upper buttock, sends mild electrical impulses to correct abnormal nerves and help muscles function properly. Although it can improve urinary urgency and frequency, it doesn’t work well for pelvic pain.

Major Surgery
Doctors only use surgery if other methods don’t relieve your symptoms, and it severely impacts your quality of life. They may consider this if your bladder can only hold a tiny amount of urine, or you're in constant, severe pain


Why Choose UHealth?

Pelvic health expertise at the Desai Sethi Urology Institute. We offer comprehensive care and services focused on women’s health and well-being. As an academic medical center, we use the latest research and leading-edge approaches to help you feel better and get back your life as quickly as possible.

Care designed for women. Our doctors specialize in women’s health. You get individual attention and treatment that’s customized to your needs, with personal attention from trained, compassionate experts who understand women’s needs.

A team approach. Your doctor works with a team of specialists to give you complete care. You can be confident you’re working with a highly trained team that’s focused on women’s health.

Expert advice. Your care team will educate you about what you can do to relieve symptoms. You get expert guidance on how to make changes to your diet and lifestyle that can help you feel better.

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