Painful Bladder Syndrome/Interstitial Cystitis (PBS/IC) is a chronic condition that involves:
- Urinary urgency
- Urinary frequency
- Nocturia (being awakened by the urge to urinate more than once per night)
- Bladder pain, which tends to increase as the bladder fills
The intensity of these symptoms may range from mild to debilitating. The presence of this syndrome suggests that there is no underlying cause for these symptoms, such as a urinary tract infection or bladder tumor. However, medical evaluation is needed to confirm the absence of these conditions or other conditions with similar symptoms.
Risks & Causes
The exact cause of PSC/IC is unknown. However, multiple factors are believed to be involved, including disruption of the bladder lining with resulting overactivity of pain-sensing nerve fibers in the bladder. Risk factors for PBS/IC include young age, female gender and a family history of PBS/IC.
Symptoms & Evaluation
The symptoms of PBS/IC often occur in episodes of increased intensity, known as "flares," followed by periods of remission. In severe cases, urinary frequency can occur more than 60 times a day during flares. Some foods and beverages, as well as tobacco, tend to make the symptoms worse. Women suffering from PBS/IC may also suffer from additional pelvic pain due to spasms of the pelvic floor muscles, irritable bowel syndrome, fibromyalgia, migraines, asthma, environmental allergies, lupus, rheumatoid arthritis, endometriosis, vulvodynia and anxiety disorders.
There is no test for the diagnosis of PBS/IC. Testing is done to rule out other possible causes of the symptoms of PBS/IC such as bladder cancer, urinary stones, sexually transmitted diseases or other gynecological problems.
Treatment Options
While there is no cure for PBS/IC, there are several surgical and non-surgical treatment options available. A combination of these options is usually required for symptom control. Finding the combination of options that will provide relief often requires diligence and patience.
Non-surgical Treatments:
Bladder diet:
Following a bladder diet means avoiding food and beverages that irritate the bladder and intensify urinary symptoms of PBS/IC. A "bladder elimination diet" is a method to determine which particular foods and beverages make your symptoms worse.
Pelvic floor therapy:
Pelvic floor therapy consists of visits to a physical therapist with specialized training in pelvic floor disorders. These specialized physical therapists utilize a combination of various techniques, listed below, depending on the type of urogynecological condition they are treating.
Bladder training:
Bladder training consists of learning to use the pelvic floor muscles to suppress overactive bladder symptoms, including urinary urgency, frequency, nocturia and urge urinary incontinence.
Functional electrical stimulation:
Functional electrical stimulation utilizes a device that can be used intravaginally or externally, delivering a gentle electrical current to activate or relax the nerves and muscles in the pelvis.
Joint and tissue mobilization:
This therapy involves gentle manipulation to help calm the muscles and nerves of the pelvis.
Bladder instillations:
Bladder instillations are repeated instillations of lidocaine, heparin and other substances into the bladder to decrease bladder pain. The mixture is instilled through a small catheter inserted into the urethra two times per week until the desired results are achieved.
Sacral nerve modulation:
Sacral nerve modulation is an FDA-approved treatment for urinary urgency, frequency, urge incontinence and retention. Sacral nerve modulation uses a small device that is implanted under the skin of one of the upper buttocks. It works by gently stimulating the sacral nerves to help the bladder function more normally.
Would you like an appointment?
To request an appointment, please call our office at (646) 962-9600. Our phone staff are available to help you Monday-Friday, from 9AM-5PM (EST).
If you'd like to learn more about our providers that specialize in Painful Bladder Syndrome/Interstitial Cystitis, please visit the "Our Care Team" page.