What is Bladder Pain Syndrome?
- BPS is one of many Chronic Pelvic Pain Syndromes.
- BPS is defined as persistent or recurrent pain perceived in the urinary bladder region, accompanied by at least one other symptom, such as pain worsening with bladder filling or day-time and/or night-time urinary frequency.
- BPS was previously known as interstitial cystitis but this term has fallen out of favour.
- BPS is an umbrella term with a number of “types” of bladder pain
Symptoms of BPS
- Pain or Pressure in the lower abdomen with bladder filling
- Pain with urination
- Frequent and urgent need to urinate
- The need to wake during the night to urinate.
- Constantly having to wait for the stream to begin, no matter how urgent it feels.
- Pain when performing basic tasks, such as driving, working, or having sexual intercourse.
What is the cause of BPS?
There is not one known cause for BPS but likely a number of different causes. Some of the proposed mechanisms include:
- Mast cell activation
- Bladder wall infection
- Autoimmune modulated
- Neurogenic pain
- Inflammation secondary to urinary toxins
- Leaky bladder lining
Getting Your Evaluation
- A clinical interview and standardized questionnaires are the most important part of the evaluation
- It is important to rule out more life threatening conditions
- Physical evaluation
- Possible Tests
How is BPS treated?
BPS is a condition with fluctuating exacerbations and remissions. The main goal of treatment is to make the symptoms more manageable and to improve your quality of life.
- LIFESTYLE directed treatment
- Stress management, improved sleep, regular exercise
- Avoid bladder irritants (a few are listed here):
- Coffee, tea (even decaf, herbal teas are ok)
- Carbonated drinks
- Acidic foods and drinks
- Spicy foods
- Artificial sweeteners
- Avoid constipation
- PHYSIOTHERAPY can help to relieve trigger points that can cause a “migraine” like pain in the pelvis
- Can be instilled into the bladder on a weekly basis for 6-8 weeks
- Other medications include:
- Bladder relaxants: Anticholinergics, B-Agonists, Botox
- Hydroxyzine (antihistamine)
- Tricyclic antidepressants
- Selective Serotonin Reuptake inhibitors
- Has a limited role
- Bladder hydro-distension can help with increasing the size of the bladder to make it react less when filling.
- Urethral Dilation
Michelle Strovski, Maple Ridge Urology, Serving Maple Ridge, Coquitlam, Mission, Abbotsford, Langley, and Vancouver.