Common causes of bladder pain are urinary tract infections, bladder stones, benign fibroids large enough to put pressure on the bladder, and bladder pain syndrome (BPS)/interstitial cystitis.
BPS is defined as bladder discomfort that lasts for at least six weeks and occurs in the absence of a urinary tract infection or other known cause.
Your physician may diagnose you with BPS based on the symptom of discomfort with a full bladder and relief upon urination, accompanied by tenderness of the bladder/urethra/pelvis on exam. Urine studies will also be sent to rule out a urinary tract infection.
Women are five times more likely to have BPS compared to men. You may be more likely to have BPS if someone in your family also does or if you have other chronic pain syndromes (endometriosis, fibromyalgia, irritable bowel syndrome), though more research is needed to find out exactly what causes BPS.
The treatment of BPS oftentimes involves a multimodal approach. Common oral medications used are amitriptyline (Elavil), pentosan polysulfate sodium (Elmiron), and hydroxyzine.
For an acute flare of bladder pain, your physician may offer you a bladder instillation, wherein a combination of medications will be placed into your bladder via a catheter in a simple office visit to help to relieve your symptoms.
In combination with these treatments, your physician may also suggest that you work with a physical therapist, a psychologist or psychiatrist, and other specialists to address additional chronic pain syndromes that are also present.
Your physician may recommend that you limit your intake of caffeine, alcohol, artificial sweeteners, and spicy foods. For some patients, these substances may trigger exacerbations of their bladder symptoms.
Hanno PM, Burks DA, Clemens JQ, et al. AUA guideline for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome. J Urol 2011; 185:2162.
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