Painful Bladder


Bladder Pain Syndrome - Overview

Bladder Pain Syndrome is difficult to diagnose because there are no single tests to determine whether you have the syndrome. However, symptoms include:

  • Intense pelvic pain - pain felt across your abdomen
  • Sudden urges to urinate
  • Needing to urinate more often than usual
  • Pain while your bladder is filling up, and relief when it is emptying.
  • Waking up several times in the night to urinate.

Other symptoms can include finding it difficult to pee, urinary incontinence and blood in your urine (haematuria).

These symptoms can sometimes be caused by other conditions, such as cancer of the bladder. This is why you'll need a range of tests to rule out other possible causes before BPS (interstitial cystitis) can be diagnosed.

Who gets BPS?

  • Most common in women over 30 years old
  • Symptoms can come and go with time, flaring up occasionally.
  • Pain be worse following your period or after eating/drinking certain foods/drinks.

What Causes Bladder Pain Syndrome?

The exact cause of BPS is unknown, but there are several ideas about what might cause it:

  • Damage to the bladder lining may cause urine to irritate surrounding nerves.
  • Problems with pelvic muscles used to control urination.
  • An inflammatory reaction caused by your immune system.

Diagnosis for Bladder Pain:

You may need to have multiple tests to diagnose Bladder Pain Syndrome, because it cannot be detected by one singular test. These can include:

  • Bladder diary
  • Cystoscopy - a procedure to look inside your bladder with a telescopic camera
  • Urine test
  • Ultrasound, of the urinary tract and potentially the kidneys.
  • Urodynamics - a range of tests to assess the functionality of the bladder and the urethra
  • Vaginal swabs

How can BPS be Treated?

You may need to try different treatments to find out which works best for you:


  • Medicines are available to treat the symptoms: painkillers, nerve pain modulators, antihistaminics.
  • Bladder Instillations - medicines can be passed directly into the bladder with a catheter. These include: lignocaine (local anaesthetic to numb the bladder), hyaluronic acid or chondroitin sulphate (to help restore the bladder lining), antibiotics (to reduce inflammation and infection).


  • Physiotherapy - a specialist pelvic floor physio can help you to ease the pain by relaxing your muscles.
  • Acupuncture
  • Counselling - to help with the impact of BPS on your life.
  • Tibial Nerve Stimulation to help reduce the urge to urinate.
  • Pain management


Surgery will normally not be recommended unless other treatment options have been unsuccessful or you have obvious abnormal areas (lesions) in your bladder.

Surgical treatments include:

  • Cauterisation - ulcers inside the bladder are sealed using an electrical current or laser
  • Bladder Distension - the bladder is filled with a fluid to stretch it. This can aid with diagnosis and relieve symptoms temporarily.
  • Botox injections - these are injected into the bladder wall to relieve the urge to urinate and pain.
  • Neuromodulation - a device is implanted to stimulate your nerves with electricity. This can relieve pain and reduce immediate urges to urinate.
  • Cystectomy - this is only done as a last case resort. The surgeon may need to create an alternate way for you to urinate.

Painful Bladder - Specialists


Dr Pallavi Latthe

Consultant Gynaecologist and subspecialist Urogynaecologist

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