Bladder Pain Syndrome – What is it?
Bladder pain syndrome is a relatively new diagnosis that was developed in the last few years from interstitial cystitis as our understanding of what is happening in the body has gotten better. Interstitial cystitis was thought to be a chronic infection of the bladder lining. It would give people an urgent need to pass urine, frequently needing to go to the toilet and it would have been accompanied by pain in the bladder region, perineum (between the legs) or in the urethra (tube from the bladder).
However, these symptoms went on longer than the infection should have and often after taking antibiotics. After many years of research it is understood that interstitial cystitis is much more complex and many people do not have a chronic infection in their bladder or urethral lining.
Therefore, a newer definition was developed which was Bladder Pain Syndrome. It is defined as pelvic pain lasting more than six weeks which gets worsening with bladder filling and improves with bladder emptying. It can give the person a persistent urge to urinate or increased urinary frequency and there may not be an identified bladder or urethral infection.
Bladder Pain Syndrome is very complex and for some reason which we are not exactly sure the brain thinks the bladder is under treat. This could be due to recurrent infection that has been fully treated or a trauma to the bladder or pelvic floor region. This means for treatment to be successfully you must sometimes treat not only the bladder but the pelvic floor muscles and the nervous system. Nobody experiences the same symptoms in the same way and some people have symptoms more severe than others.
Who gets Bladder Pain Syndrome?
It effects mostly women in their childbearing years (20-60years) and there may be a slight genetic component to the syndrome. It can affect men however the ratio of women to men with the diagnosis is 10:1. It is a diagnosis of exclusion. What that means is that other more serious conditions need to be excluded first. This means for some people it can take a long time to receive the correct diagnosis and treatment. It is estimated in the UK that 2.6million women suffer from BPS. At present there doesn’t appear to be any statistics available for Ireland.
How can it be treated?
Following a diagnosis of Bladder Pain Syndrome the physiotherapy treatment is done in conjunction with your G.P. or specialist. From a physiotherapists perspective there are a variety of treatment options that can assist with symptoms remembering that everyone is different. The treatment is not just confined to the bladder or pelvic floor although that is part of the process.
The treatment options can include bladder retraining, physiotherapy exercises or massage to relax the muscles of the abdomen and pelvic floor, mindfulness or relaxation techniques, working with the individual to identify triggers or stress in their lives that may cause symptoms to flare up and looking at the diet to make sure there are to eliminate any foods that are bladder irritants.