Bladder Pain Syndrome / Interstitial Cystitis
These conditions are characterised by bladder, pelvic or urethral pain when the bladder is full. The pain is usually relieved by emptying the bladder. There may be pain on urination (dysuria). Patients often have to go to the toilet very frequently because of the bladder pain. When the conditions starts it is often thought to be cystitis caused by urinary tract infection but the symptoms do not improve after antibiotic treatment.
How is a bladder pain syndrome diagnosed?
Many conditions can cause pain when the bladder fills up and generally these are the easiest to treat. It is therfore very important to rule out other causes of bladder and pelvic pain such as - urinary tract infection, overactive bladder, bladder cancer and gynaecological conditions.
Patients who have pain on bladder filling with no underlying cause found may then be diagnosed with a bladder pain syndrome. Most patients will then undergo a diagnostic cystoscopy, gentle bladder stretch (cystodistension) and bladder biopsy - in some patients the bladder can be seen to be very inflamed, even ulcerated with a reduced bladder capacity - patients with bladder pain symptoms and these findings have a sub-type of bladder pain syndrome called interstitial cystitis.
What causes bladder pain syndrome / interstitial cystitis?
It is likely that the bladder wall lining becomes leaky and allows toxins (potassium ions) normally concentrated in the urine to get into the bladder wall. This then sets up a cycle of inflammation and activates the nerves which transmit painful signals.
What treatments are available?
There are a large number of treatments for bladder pain syndrome and the treatment should be tailored to your specific needs. We only recommend medical treatments that are backed up by good medical evidence. Treatments we offer include -
Oral therapies - Include tablets that reduce bladder inflammation, modify bladder function or help recoat the bladder lining.
Intravesical therapies -Using a catheter to fill the bladder with solutions which coat the bladder lining.
Cystodistension and ulcer destruction - stretching the bladder often improves symptoms. If ulceration is seen (Hunners Ulcers), destroying the ulcers with diathermy can be very effective at releiving painful symptoms.
Botox Bladder Injection - In addition to cystodistension this can improve symptoms particularly if there are overactive bladder symptoms.
Bladder Replacement Surgery - In severe cases where other measures have failed the diseased bladder can be removed and reconstructed using a segment of the bowel.
We will support you throughout your treatment. The Cystitis and Overactive Bladder Foundation is an excellent patient support group - it helps to know that you are not alone!