There are several possible causes of bladder pain, including infections, interstitial cystitis and bladder cancer.
Interstitial cystitis (IC) is a chronic condition in which the bladder becomes inflamed and irritated. The inflammation stiffens the bladder wall and makes it difficult for the bladder to fully expand when filling with urine. IC may be caused by a defect in the bladder lining. Women are much more likely than men to have the condition.
A main symptom is pain, which is strongest when the bladder fills and eases when the bladder empties. Pain may also be felt more generally in the lower back, abdomen or perineal area. People with this condition may also urinate more frequently or feel an urgent need to urinate, yet they may only pass a little bit of urine each time. Sexual problems may be related to interstitial cystitis.
Often a diagnosis of IC is made by ruling out other conditions that cause similar symptoms, such as urinary tract infections, vaginal infections, kidney stones and cancer. Your GP will take a medical history and perform a physical examination. You may be asked how often you go to the toilet, if you feel an urgency to go and when you experience pain.
The following tests may be done:
- Urine sample
- Cystoscopy - After your bladder is filled with a liquid, the doctor will insert a long, thin scope (cystoscope) through your urethra to view the inside of your bladder.
Several treatments may help relieve symptoms of bladder pain and urgency, but finding the one that works for you is often a matter of trial and error. Here are some treatment options:
Medications: Medications used to treat IC include over-the-counter pain relievers such as aspirin, ibuprofen or paracetamol; tricyclic antidepressants; cimetidine; and anticholinergics such as oxybutynin, tolterodine,
Bladder instillation: A thin tube (catheter) is used to fill your bladder with dimethyl sulfoxide, which is kept in the bladder for 15 minutes then voided. Treatments can be given every couple of weeks in 8-week cycles, This treatment is thought to work by reducing inflammation and decreasing the sensation of pain.
Bladder distension: While you are asleep under anaesthesia, the doctor fills your bladder with a liquid to stretch its walls. Bladder distension is a technique used to diagnose IC, but it also helps relieve pain for some patients, possibly because it increases the bladder capacity or interferes with the nerves that transmit pain signals from the bladder.
Nerve stimulation: For some patients, a technique called transcutaneous electrical nerve stimulation (TENS) helps relieve pain and the urge to urinate. Electrodes placed on the skin or implanted in the body send electrical impulses to the nerves controlling the bladder. This technique can help strengthen the muscles controlling the bladder, and may trigger the release of chemicals that block pain.