Symptoms and Treatment of Painful Bladder Syndrome (PBS)

Painful Bladder Syndrome (PBS), also known as Interstitial cystitis (IC) cannot be diagnosed easily as the various symptoms this ailment are common to other diseases. There appear to be a link between the IC and other diseases and syndromes such as chronic vulvar vestibulitis, fibromyalgia and irritable bowel syndrome. This disease can be debilitating and may lead to feelings of helplessness and hopelessness in patients who suffer from it.

 

Painful Bladder Syndrome (PBS) is also known as  Interstitial cystitis (IC) that causes chronic inflammation of the urinary bladder.

Unlike ordinary cystitis, IC is probably not caused by bacteria and does not respond to conventional antibiotic treatments. It is important to note that the IC is not a psychosomatic illness, and is not caused by the stress.

Interstitial cystitis (IC) can affect men and women of all ages and ethnicity, but it is nevertheless observed primarily among women. According to epidemiological estimate data there are over 700 000 people with IC the United States alone.

The suffering due to IC on the lives of patients should not be underestimated. This disease can be debilitating and may lead to feelings of helplessness and hopelessness in patients. 

SYMPTOMS

Several or all of the following symptoms may be present in Interstitial cystitis:

  • Frequent urination day and / or night, of up to 60 times daily in acute cases. Sometimes, at the initial stage of the disease or in mild cases, the frequency is the only symptom.
  • The patient feels urgency for urination that can cause pain, pressure sensation or spasms of the bladder.
  • Pain can be either Lower abdominal, vaginal or urethral. Pain is commonly experienced during sexual intercourse. Men with IC may feel testicular pain, scrotal and / or perineal, and during ejaculation.
  • In addition to the symptoms described above, some patients also may have muscle and joint pain, headaches, reactions allergic and gastrointestinal disorders. 
  • There appears to be a link  between the IC and other diseases and syndromes such as chronic vulvar vestibulitis, fibromyalgia and irritable bowel syndrome.
  • Most patients however, have only bladder symptoms.

Image By Jordi March i Nogué via Wikimedia Commons

DIAGNOSIS:

It is difficult to arrive at a diagnosis for most patients with IC. The urologist may suggest you to undergo the following procedures to make a correct diagnosis:

Urine cultures to determine the presence of a bacterial infection 

  • Exclusion of other diseases and / or disorders with symptoms similar to those of the IC (such as kidney disease, bladder infections, bladder cancer, tuberculosis, vaginal diseases, venereal disease, neurological disorders, endometriosis, and radiation cystitis)
  • Cystoscopy under general anesthesia with hydrodistension if no infection is present and no other disease is detected. 
  • Distention of bladder under anesthesia is required to establish the diagnosis of IC, as a simple cystoscopy does not always identify the typical characteristics of IC and can be very painful for patients. It is therefore necessary to dilate the bladder under general or local anesthesia , to detect tiny hemorrhages on the bladder wall indicative of IC. 
  • A biopsy of the bladder wall may be necessary to exclude any another illness, such as cancer, and confirm the diagnosis as IC is not associated with bladder cancer.

TREATMENT AND MANAGEMENT

Currently, there is no single cure for IC, nor a therapeutic approach only effective for all IC patients. However,a large majority of patients with IC  respond favorably to one or more of the following treatments:

  • Elmiron™  (Pentosan polysulfate sodium) is the only oral medication that acts by restoring the bladder mucosa thinned or damaged. Oral medication also includes some anti-inflammatory drugs, antispasmodic, bladder analgesics,  antihistamines and muscle relaxants.
  • DIET: Eliminating acidic or spicy foods  may relieve symptoms associated with IC. Avoiding  smoking, coffee, tea and alcohol can also relieve the  symptoms.
  • SELF-MANAGEMENT: Patients can take certain measures care to improve their quality of life. These techniques  include dietary changes, stress reduction, visualization exercises and biofeedback, and other physical exercises for bladder rehabilitation.
  • ELECTROSTIMULATION such as Transcutaneous Electrical Nerve Stimulation  (TENS) relieves bladder pain in some patients.
  • SURGERY may be considered for few patients with particularly pronounced symptoms and an inadequate response to the above treatments. There are several types of surgeries to  treat IC, including cystectomy (removal of the bladder) and urinary diversion

References:

Brochures and fact sheets on these treatments are available with Interstitial Cystitis Association (ICA). Click here for ICA.

ELMIRON®

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