Bladder iInflammation, or interstitial cystitis, is now often diagnosed as Painful Bladder Syndrome (PBS). ) This is a condition that results in recurring pain or discomfort of the bladder and the surrounding pelvic area. It is estimated that up to one million Americans suffer from bladder inflammation. Up to 90% of those afflicted with this condition are female.
The cause of painful bladder inflammation is unknown. Theories suggest that it is an autoimmune, hereditary, infectious, or allergic condition, but none have been proven. An irregularly formed bladder could cause bladder inflammation. Although symptoms are similar to those of a bladder infection (cystitis), urine cultures have no growth of bacteria, and the patient is unresponsive to trials of antibiotics. Untreated bladder inflammation can lead to scarring and formation of stones if urine is retained for long periods of time to avoid painful urination. Listed are symptoms associated with bladder inflammation.
Painful urination is a common symptom of bladder inflammation. The pain comes from an irritated, inflamed bladder wall that becomes stiff from the soreness and cannot expand when filled with urine. The pain may intensify as the bladder fills with urine, or as the bladder empties. Sores, called Hunner’s ulcers, may develop in the bladder and can cause minor bleeding. Tenderness and pain tend to radiate to the surrounding areas of the pelvis and perineum in females, and to the scrotum and perineum in males. The pain often worsens in women during their menstruation cycle. Sexual intercourse is painful for both men and women who have bladder inflammation.
People suffering from bladder inflammation feel the urge to have to urinate frequently, up to 60 times a day and night (nocturia). The National Institutes of Health report that although the urge to urinate is strong, there will be just a small trickle of urine produced when urinating. The urgency to urinate is similar to those who drink large quantities of liquids, or people who take diuretic medications.
People with bladder inflammation experience a sensation of burning when urinating, and they continuously leak small amounts of urine. Burning sensation with urination is also a symptom of a urinary tract infection (UTI), which is caused by a bacterial infection. If UTI is present, there will be a positive urine culture showing bacteria are present in the urine. People with bladder inflammation have negative urine cultures, because there are no bacteria present causing an infection.
PBS is diagnosed by the presence of pain in the bladder, urgency with frequent urination producing only small amounts of urine, and a burning sensation present when urinating. Diagnostic tests include urinalysis, urine or prostatic fluid cultures, cystoscopy, biopsies of the bladder wall and urethra. Other diseases must be ruled out as a cause of the inflammation.
Treatments for PBS include oral medications such as Ibuprofen and other pain medications, and the use of Elmiron 100 mgs. three times daily. This drug improved symptoms in about 30% of patients with bladder inflammation. Another treatment is electrical nerve stimulation used to stimulate the nerves of the bladder. This can be done through the skin or with an implanted device. Electrical nerve stimulation may increase blood flow to the bladder, strengthen bladder muscles, or cause the release of substances that stop pain. Dietary measures include avoiding alcohol, tomatoes, spices, caffeine, and chocolate. People report that smoking makes their symptoms worse. Using bladder training techniques are used to help reduce the urgency and frequency of urination.