Question 1

What is painful bladder syndrome or interstitial cystitis?

Accepted Answer

Painful bladder syndrome, often referred to as interstitial cystitis (IC), is a chronic condition characterized by bladder pain, pressure, or burning, often accompanied by urinary urgency and frequency, without evidence of an active infection.

Question 2

What are the symptoms of painful bladder syndrome?

Accepted Answer

Symptoms vary but commonly include:

• Bladder or pelvic pain
 • Urinary urgency or frequency
 • Pain that worsens as the bladder fills and improves after urinating
 • Discomfort with intercourse
 • Sensitivity to certain foods or beverages
 • Persistent urinary symptoms despite negative urine cultures

Patients with painful bladder syndrome often have overlapping symptoms related to overactive bladder or recurrent urinary tract infections.

Question 3

What causes painful bladder syndrome?

Accepted Answer

The exact cause is not fully understood. It is believed to involve bladder lining dysfunction, nerve hypersensitivity, pelvic floor muscle tension, inflammation, and altered pain signaling. Many patients have overlapping pelvic conditions.

Question 4

How is painful bladder syndrome diagnosed?

Accepted Answer

Diagnosis includes a detailed review of symptoms, prior testing, and response to treatments. Evaluation often includes urine testing to rule out infection, pelvic examination, and assessment of pelvic floor muscle function. In some cases, cystoscopy is recommended to evaluate the bladder lining and exclude other causes of pain.

Question 5

How is painful bladder syndrome treated?

Accepted Answer

Treatment for painful bladder syndrome focuses on reducing bladder irritation, calming pain signals, and addressing contributing pelvic and hormonal factors. Because symptoms and triggers vary, treatment is individualized and often involves a combination of therapies, including:

• Pelvic floor physical therapy
Addresses pelvic floor muscle tension and dysfunction, which commonly contribute to bladder pain, urgency, and frequency.
 • Bladder retraining and behavioral strategies
Helps reduce urinary urgency and frequency while minimizing bladder hypersensitivity.
 • Dietary modifications
Identifies and avoids common bladder irritants such as caffeine, alcohol, acidic foods, spicy foods, and artificial sweeteners.
 • Medications
May be used to reduce bladder inflammation, calm nerve hypersensitivity, or manage chronic pain associated with bladder irritation.
 • Bladder instillations or bladder lavages
In-office treatments that involve instilling therapeutic solutions into the bladder to help soothe the bladder lining, reduce inflammation, and relieve pain in selected patients.
 • Hormonal support when appropriate
Vaginal estrogen therapy may be beneficial, particularly in postmenopausal women, to improve tissue health and reduce bladder sensitivity.

Treatment is typically stepwise, starting with conservative therapies and advancing as needed. The goal is symptom control, improved bladder comfort, and restoration of quality of life rather than a one-size-fits-all solution.

Question 6

Is painful bladder syndrome the same as recurrent UTIs?

Accepted Answer

No. Painful bladder syndrome is not caused by an active infection, although symptoms may feel similar. Differentiating between infection and bladder pain syndrome is critical to avoid unnecessary antibiotic use.

Question 7

Can menopause affect painful bladder symptoms?

Accepted Answer

Yes. Hormonal changes during menopause can affect bladder and vaginal tissue health and may worsen bladder sensitivity and urinary symptoms.

Question 8

When should I see a urogynecologist for bladder pain?

Accepted Answer

You should seek specialized care if bladder pain or urinary symptoms persist despite negative urine cultures, repeated antibiotic treatments, or standard UTI therapy.

Painful Bladder Syndrome