Painful Bladder Syndrome

Causes

Although the symptoms are similar to those of a bladder infection , there is usually no clear cause. Bacteria, fungi, and/or viruses are rarely found in the urine (pee) of people with interstitial cystitis. Possible causes include:

• The body's immune system attacks the bladder
• Irritating substances in urine leak through the inner lining of the bladder

Risk Factors

Interstitial cystitis is more common in women.

Other things that may raise the risk of interstitial cystitis are:

• Past urinary tract infections
• Irritable bowel syndrome
• Pain disorders, such as fibromyalgia or chronic fatigue syndrome

Symptoms

The symptoms of interstitial cystitis vary from person to person. They can also happen in cycles. Symptoms may include:

• Urgent or frequent need to urinate (pee).
• Pain or pressure in the bladder or pelvic area when the bladder is full—and relief when the bladder is emptied
• Pain during and after intercourse or during orgasms
• Blood in the urine
• Depression
• Pain in the vulva or vagina in women—or in the testicles, groin, or tip of penis in men

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. It will include the belly, pelvic organs, and rectum.

Diagnosis of interstitial cystitis is based on symptoms and ruling out other problems. A urine test and urine culture may be done to look for an infection. The doctor may also look for other problems in the bladder with a scope.

Treatment

There is no known treatment to cure interstitial cystitis. Treatment is aimed at managing symptoms. Several different treatments may be needed before symptoms improve.

Treatment may include one or more of the following:

Lifestyle changes, such as:

• Avoiding foods and drinks that seem to irritate the bladder, such as:
• Coffee
• Chocolate
• Artificial sweeteners
• Alcohol
• Acidic foods
• Fizzy drinks
• Counseling to help with coping and relaxation—since stress can worsen symptoms
• Physical therapy exercises to strengthen the pelvic floor

If lifestyle changes do not help enough, the doctor may advise medicines to:

• Ease pain
• Reduce irritation
• Decrease spasms and slow nerves
• Adjust the immune system—if other methods do not help

Medicines may be taken by mouth or put directly in the bladder with a tube (catheter).

Other methods that help some people feel better include:

• Bladder distention or instillation—water or a solution is put into the bladder, held for a time, then urinated out
• Nerve stimulation—a device sends mild electrical impulses to the body to help ease symptoms

Surgery may help people with severe symptoms that do not get better. Options may be:

• Ulcer fulguration—instruments inserted through the urethra are used to burn ulcers with electricity or laser
• Ulcer removal—instruments inserted through the urethra are used to cut out ulcers
• Bladder augmentation—a piece of bowel is used to increase the amount of urine the bladder holds
• Cystectomy —the entire bladder is removed

Prevention

There are no current guidelines for preventing interstitial cystitis.