The condition that is most commonly referred to as painful bladder syndrome is actually a condition known in the medical realm as interstitial cystitis.
This is a condition that is characterized by pressure and pain in the bladder and in some cases, pelvic pain that ranges from a mild discomfort to an excruciating pain.
Your bladder is a muscular organ where your urine is stored. Your bladder will expand until it is full and then it will send a signal to your brain that it is necessary to urinate- this communication is done via the nerves located in the pelvis.
However, if you are dealing with the condition of interstitial cystitis, you know that these urination signals often get confused, and you feel like you need to go more often with much lower amounts of urine than most people.
This condition affects women much more than it does men and can cause some significant problems with her quality of life. Though there is not a particular treatment that is able to eliminate the condition, there are plenty of ways that you can find some relief.
What Causes Interstitial Cystitis?
The truth is, the root cause of this particular condition is not clear, but what is clear is that there are many factors that are at play.
For example, individuals with this condition might have a defect in the epithelium, or protective lining, of their bladder. This defect allows for toxic substances in your urine to cause irritation to the wall of your bladder.
On the other hand, some of the other possible causes are heredity, allergy, infections or an autoimmune reaction.
Risk Factors for Interstitial Cystitis
Following are the common risk factors that are associated with the condition of interstitial cystitis:
Sex: as already stated, this condition affects women much more often than it does men. Of course, men can have symptoms that are almost identical to those of interstitial cystitis, but these are often due to the prostate gland becoming inflamed.
Age: in most cases, individuals with this condition will be diagnosed around the age of 30 or older.
Chronic Pain Disorders: in many cases, the condition of interstitial cystitis is often co-existing with other chronic pain conditions such as fibromyalgia or irritable bowel syndrome.
Common Medical Treatments and Medications
You must know that there is no specific, simple treatment that can eliminate the signs and symptoms of the condition of interstitial cystitis.
In addition, there is no “one-size-fits-all” treatment- everyone is different, after all. Chances are, you will need to try out several different treatment options or even combinations of treatments before you are able to find one that works well for you.
Physical Therapy: doing physical therapy could possibly help to relieve the pelvic pain that is often characterized by tenderness of the muscles, connective tissue restrictions, and even abnormalities of the muscles in the floor of your pelvis.
Oral Medications: Following are some of the common oral medications that may help with the condition of interstitial cystitis:
- NSAIDs: these include naproxen and ibuprofen and can help with the inflammation due to interstitial cystitis
- Tricyclic antidepressants: these include imipramine or amitriptyline and can offer relaxation to your bladder, blocking pain
Antihistamines: these include loratadine and others which can help to reduce the urgency and frequency of urination and can help to relieve any of the other signs and symptoms
Pentosan: this is a medication that has been approved by the FDA specifically to treat the condition of interstitial cystitis.
It is not clear how exactly it works, but it’s possible that it restores the inner surface of the bladder, protecting the wall of the bladder from any substances in the urine that could cause irritation.
It could take two to four months before you feel any relief and even up to six months before the frequency of urination slows down.
Nerve Stimulation: these techniques stimulate the pelvic/bladder nerves and includes the following:
TENS: with this nerve stimulation therapy, mild electrical impulses will be delivered to the nerves and will relieve the pain in the pelvic region as well as reduce the frequency of urination.
It is thought that TENS helps because it increases flow of blood to the bladder, and strengthens the muscles that help to control the bladder.
Electrical wires will be placed on your lower back or even just above you pubic region. The length and frequency of the TENS therapy depends upon what is working best for you.
Sacral nerve stimulation: you should know that your sacral nerves are the main link between your bladder nerves and spinal cord.
Stimulation of these nerves could reduce the urgency of urination that is associated with the condition of interstitial cystitis.
A thin wire will be placed near the sacral nerve and will deliver electrical impulses- which is almost like what a pacemaker does for your heart. If the procedure is working for you, the physician may wish to surgically implant a device.
Bladder distention: some individuals notice a short-term improvement in their symptoms of interstitial cystitis following a cystoscopy with bladder distention- which is stretching the bladder with gas or water. If the response is long-lasting, the procedure may be repeated.
Medications put into bladder: with this procedure, your physician will fill your bladder with a medication called dimethyl sulfoxide with a flexible, thin tube.
This tube, known as a catheter, is inserted through your urethra. In some cases, it will be mixed with other medications, such as an anesthetic.
It will remain in the bladder for about fifteen minutes and then you will urinate it out. This will likely be done once a week for 6-8 weeks and then will use it for maintenance as needed.
Surgery: as a last resort, your physician may turn to surgery. However, keep in mind that removing part- or even all- of the bladder will not relieve the pain associated with this condition and can also lead to some other serious complications.
Still, individuals with severe cases or small bladders are often candidates for surgery- usually only after all other options have failed. There are several different types of surgery:
- Fulguration: minimally invasive and involves inserting instruments to burn off any ulcers that are present
- Resection: also minimally invasive, involving inserting instruments to cut out any ulcers
- Augmentation of bladder: physician will remove a portion of the bladder and replace it with a section of the colon. The pain still remains and some individuals will need to use a catheter several times each day.
