Bladder pain syndrome or interstitial cystitis
What is bladder pain syndrome/interstitial cystitis?
Interstitial cystitis (also known as bladder pain syndrome) is a chronic condition that leads to pain in your bladder or water pipe (urethra) and the need to pass urine very often. The pain can be very severe and can affect your ability to sleep, work or enjoy a normal sex life. Although there is no cure for this condition, there are a number of things you can do to improve your symptoms and we will discuss all these options with you at your consultation.
Mr Malde offers specialist appointments for further investigation and treatment for male and female patients at his private urology clinics across London.
How common is this condition?
It is a common condition that can affect both men and women, although it is more common in women. It is most common in patients aged 30-50 years old and affects around 1 in 50 women.
What are the symptoms of bladder pain syndrome/interstitial cystitis?
The symptoms of bladder pain syndrome/interstitial cystitis can vary between individuals and may come and go with time. The typical symptoms include:
Pain or discomfort in your bladder, urethra, groin, pelvis, lower abdomen or lower back. It may get worse when your bladder is filling up and you may find that it improves slightly after you have passed urine
Passing urine more frequently during the day and night but passing small volumes each time
A constant feeling that you need to urinate
Pain during sexual intercourse
The symptoms can be extremely distressing and if you are concerned about this you should contact us and make an appointment.
What causes bladder pain syndrome/interstitial cystitis?
The exact cause of bladder pain syndrome/interstitial cystitis is not known but some theories are:
There is a defect in the protective layer that lines the inside of your bladder. As a result, irritating chemicals in your urine can pass through your bladder and cause pain
The nerves that normally send signals from your bladder are over-sensitive, so pain is caused by things that are not normally painful (such as your bladder filling with urine)
How can this condition be treated?
There is no cure for this condition but there are a number of options for improving your symptoms.
Conservative measures:
Changes to your diet/lifestyle. It is known that certain types of foods (e.g. spicy foods, caffeine, acidic foods) can make the symptoms of this condition worse in some people. We will ask you to keep a food diary to work out if there are any foods that are making your symptoms worse and if so will ask you to eliminate these foods from your diet
Reduce stress/anxiety levels. In some patients, stress and anxiety can make their symptoms worse and we will discuss different techniques to reduce stress and anxiety levels at your consultation
Bladder training. The aim of bladder training is to slowly train the bladder to hold larger and larger volumes of urine, thereby improving your symptoms. We will explain how to do bladder training at your consultation
Physiotherapy. Seeing a physiotherapist to help relax your pelvic floor muscles has been shown to help improve the symptoms of pain in some patients
Medications:
There are many different medications which may be recommended for you to either treat the over-sensitive bladder nerves, to help prevent the effects of the irritating chemicals in your urine, to help repair the lining of your bladder or to help relax your bladder muscles. We will discuss the options available at your consultation.
Bladder instillations:
If the medications do not improve your symptoms, we may consider a course of treatments that involve passing a chemical into your bladder through a small plastic tube (catheter) to help repair the lining of your bladder. The initial treatment course is typically once a week for six weeks and each instillation takes approximately one hour.
Surgery:
For some people with more severe symptoms, surgery may be required. There are a number of procedures available:
Bladder stretch. This procedure involved passing a telescope (cystoscopy) into your bladder under general anaesthetic and over-stretching it with fluid. Some people find that this helps improve their symptoms
Laser to bladder ulcers. This procedure involved passing a telescope (cystoscopy) into your bladder under general anaesthetic and treating any ulcerated areas with a laser. It has been shown to give good pain relief in some patients
Botox injections into your bladder. This involves injecting botulinum toxin A (botox) into your bladder to improve your bladder pain. It is performed under local anaesthetic through a small, flexible telescope (cystoscopy) that is passed through your water pipe (urethra) and into your bladder
Sacral nerve stimulation (sacral neuromodulation). This procedure may be considered if your symptoms are uncontrolled despite the above measures. It involves inserting a small pacemaker-like device under the skin of your lower back to send electrical signals to the nerves that control your bladder. The treatment involves two separate operations a few weeks apart. The first stage involves inserting a temporary test wire to the nerves that supply your bladder to see if the treatment will work well for you. The second stage involves inserting a permanent device under the skin of your lower back if you have found the test phase to be effective in treating your symptoms
Other surgical procedures are undertaken in some cases and we will discuss this with you in more detail if required at your consultation
How we can help you
Mr Malde has specialist expertise in treating men and women with bladder pain syndrome/interstitial cystitis. You can make an appointment at any of his specialist private urology clinics across London. He offers the whole range of treatment options for this condition and will discuss the most suitable treatment for your specific case at your consultation.