Understanding and treating bladder pain syndrome (interstitial cystitis)

When bladder pain persists without infection, specialist care can help you find relief and improve your quality of life

Bladder pain syndrome (BPS), also known as interstitial cystitis (IC), is a chronic condition that causes bladder pain, pressure, and a persistent, urgent need to urinate - often without any sign of infection.

If you’ve been experiencing bladder pain and urgency that doesn’t respond to antibiotics, or if you’ve been told “there’s no infection” despite ongoing symptoms, you may have bladder pain syndrome. This condition can significantly impact your daily life, but with proper diagnosis and treatment, relief is possible.

At The Women’s Health Vulvo-Vaginal & Genitourinary Clinic, we specialise in diagnosing and treating bladder pain syndrome. Our team provides comprehensive care to help you manage your symptoms and improve your quality of life.

Bladder pain syndrome is real and treatable. Let us help you find relief.

Do you have bladder pain syndrome?

You may have bladder pain syndrome if you experience:

Chronic bladder pain or pressure lasting 6+ months
Urgent, frequent need to urinate (often 20-40+ times per day)
Pelvic pain that improves temporarily after urination
Pain during or after sexual intercourse
Waking multiple times at night to urinate
Symptoms that worsen with certain foods or drinks
Tests showing no infection despite ongoing symptoms
Impact on your work, relationships, and quality of life

If this sounds familiar, it’s time for a specialist assessment.

Common causes and contributing factors

1. Bladder Lining Defects

The protective lining of the bladder (glycosaminoglycan layer) may be damaged, allowing irritating substances in urine to reach the bladder wall.

2. Mast Cell Activation

Increased numbers of mast cells in the bladder wall release histamine and other inflammatory substances, causing pain and urgency.

3. Pelvic Floor Dysfunction

Tight, overactive pelvic floor muscles often accompany bladder pain syndrome and can worsen symptoms.

4. Nerve Sensitisation

Nerves in the bladder and pelvic region may become hypersensitive, sending pain signals even without tissue damage.

5. Autoimmune Factors

Some researchers believe bladder pain syndrome may have an autoimmune component, though this is not fully understood.

6. Previous Infections or Trauma

Recurrent UTIs, surgery, or trauma may trigger the development of bladder pain syndrome in some women.

7. Dietary Triggers

Certain foods and drinks (caffeine, alcohol, acidic foods, artificial sweeteners) can worsen symptoms in many women.

How we diagnose and treat bladder pain syndrome

Comprehensive history

We’ll discuss:

When symptoms started and how they’ve progressed
Frequency and urgency patterns
Pain characteristics and location
Dietary and lifestyle triggers
Previous treatments and their effectiveness
Impact on your daily life, work, and relationships
Medical history, including UTIs and pelvic conditions

Thorough examination

A careful examination can help:

Rule out other conditions with similar symptoms
Assess pelvic floor muscle tension
Identify areas of bladder or pelvic tenderness

Appropriate testing

When needed, we may perform:

Urinalysis and urine culture to rule out infection
Bladder diary to track voiding patterns
Post-void residual measurement
Cystoscopy (if indicated) to examine the bladder lining
Urodynamic testing (in selected cases)

Personalised treatment plan

Treatment for bladder pain syndrome is multi-faceted and may include:

Bladder instillation therapy
Oral medications
Pelvic floor physiotherapy
Dietary modifications
Lifestyle modifications
For severe cases, treatments include TENS, botox and surgery

Frequently asked questions

Q: Is bladder pain syndrome the same as a UTI?

A: No, bladder pain syndrome is not an infection. Whilst symptoms can be similar to a UTI, tests will show no bacteria present. BPS is a chronic inflammatory condition.

Q: Will bladder pain syndrome go away on its own?

A: BPS is a chronic condition that typically requires ongoing management. However, with proper treatment, many women experience significant improvement and can achieve long periods of remission.

Q: How long does treatment take to work?

A: This varies depending on the treatment and individual response. Some treatments (like bladder instillations) may provide relief within weeks, whilst others (like oral medications) may take 2-3 months to show full benefit.

Q: Can diet really make a difference?

A: Yes, many women with BPS find that certain foods and drinks trigger their symptoms. Common triggers include caffeine, alcohol, acidic foods, spicy foods, and artificial sweeteners. Identifying and avoiding your personal triggers can significantly improve symptoms.

Q: Is bladder pain syndrome psychological?

A: No, BPS is a real, physical condition involving bladder inflammation and nerve sensitisation. Whilst stress can worsen symptoms, it is not the cause.

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Take the first step towards relief

Bladder pain syndrome can be challenging, but with proper diagnosis and a comprehensive treatment approach, most women experience significant improvement in their symptoms and quality of life.