What is it about ?
Painful bladder syndrome is a type of chronic inflammation of the bladder. Various factors are likely to play a role in the development of painful bladder syndrome, including a disorder of the immune system and an inflammatory reaction.
In whom and how often does it occur?
Worldwide estimates vary between 4 and 870 per 100,000 people. The condition is 10 times more common in women than in men.
How to recognize it?
A syndrome is a condition characterized by a combination of symptoms. Painful bladder syndrome may present with the following symptoms:
- Frequent need to urinate ;
- Urinary urgency;
- Need to get up at night to urinate ;
- Pain during intercourse;
- Pain in the lower abdomen, which increases as the bladder fills and which temporarily decreases after urinating.
How is the diagnosis made?
Diagnosis is based on the combination of symptoms and the result of urinalysis. Urinalysis shows no signs of UTI. To objectify the symptoms, the doctor can use questionnaires that allow you to indicate the degree of severity of the complaints.
A urodynamic assessment can also be performed as a supplement. The test involves filling the bladder through a catheter and assessing the urgency to urinate. If you have painful bladder syndrome, you will quickly want to urinate, even if your bladder is only 100 to 150 ml of fluid. Also, the maximum amount of fluid that the bladder can hold is limited to 400 ml.
A cystoscope, an instrument that examines the inside of the bladder through the urethra, provides an accurate picture of the inside of the bladder. If necessary, a bladder biopsy will be performed. The procedure involves taking a small piece of the bladder wall for examination under a microscope.
What can you do ?
Certain food products can sometimes worsen the symptoms: this is particularly the case of soft drinks, strong spices, coffee, citrus fruits, alcohol (red wine), tomatoes, bananas, chocolate, etc. These foods can irritate the bladder. If you notice that certain products make your symptoms worse, avoid them or consume them in moderation.
Exposure to cold can also have an irritant effect.
What can your doctor do?
There are a number of possible treatments, but the results vary greatly from person to person. Symptoms may not go away after treatment. The best balance is sought between the severity of symptoms and the possible side effects of the proposed treatment or intervention.
The different treatment options are:
- medicines to be taken by mouth, such as classic painkillers and anti-inflammatories, or older-generation antidepressants, such as amitriptyline, which affect the nervous pathways;
- ‘cleansing’ the bladder with a specific solution (intravesical instillation);
- distension of the bladder wall by maximum filling (hydrodistension). This intervention is performed under anesthesia. It increases the capacity of the bladder. Unfortunately, repeated treatments can also damage the bladder wall. In addition, the effect is usually only temporary.
Surgical treatment may be considered when other treatments have not improved and you are suffering from severe symptoms. The ureters can be detached from the bladder and diverted to the wall of the belly (urostomy, a kind of stoma in the bladder). In this case, the bladder is usually removed during the procedure. In younger people, a new bladder is sometimes made from a piece of intestine (bladder reconstruction).
Want to know more?
- Non-steroidal anti-inflammatory drugs – CBIP – Belgian Center for Pharmacotherapeutic Information
- Amitriptyline – CBIP – Belgian Center for Pharmacotherapeutic Information
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