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Bladder Pain Syndrome in Women

Educational Objective
To understand how to diagnose and treat Bladder Pain Syndrome in women
1 Credit CME

Bladder pain syndrome (BPS) is a common chronic pelvic pain condition that affects an estimated 7.9 million women in the United States.1 Although the nomenclature for BPS remains controversial, the American Urological Association defines BPS/interstitial cystitis as “an unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms of more than six weeks duration, in the absence of infection or other identifiable causes.”1 Patients may present to several different clinicians and describe “flares” of worsening symptoms triggered by stress, intercourse, menses, or diet.

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Article Information

Corresponding Author: Larissa Bresler, MD, Department of Urology, Stritch School of Medicine, Loyola University Chicago, 2160 S First Ave, Maywood, IL 60153 (lbresler@lumc.edu).

Published Online: November 22, 2019. doi:10.1001/jama.2019.16927

Conflict of Interest Disclosures: Dr Bresler reported receipt of grants from the Interstitial Cystitis Association. Dr Fitzgerald reported receiving personal fees from UpToDate; Loyola University Chicago; Loyola Medical Center; Blasingame, Burch, Garrard, & Ashley PC; PainWeek; Springer; Salvi, Schostok, & Pritchard PC; and Wagstaff & Cartmell LLP; receiving grants from the National Institutes of Health; serving as president of the International Pelvic Pain Society; and holding a device patent (no royalties received). No other disclosures were reported.

References
1.
Hanno  PM, Erickson  D, Moldwin  R, Faraday  MM; American Urological Association.  Diagnosis and treatment of interstitial cystitis/bladder pain syndrome: AUA guideline amendment.  J Urol. 2015;193(5):1545-1553. doi:10.1016/j.juro.2015.01.086PubMedGoogle ScholarCrossref
2.
Peters  KM, Carrico  DJ, Kalinowski  SE, Ibrahim  IA, Diokno  AC.  Prevalence of pelvic floor dysfunction in patients with interstitial cystitis.  Urology. 2007;70(1):16-18. doi:10.1016/j.urology.2007.02.067PubMedGoogle ScholarCrossref
3.
Yang  CC, Miller  JL, Omidpanah  A, Krieger  JN.  Physical examination for men and women with urologic chronic pelvic pain syndrome: a MAPP (Multidisciplinary Approach to the Study of Chronic Pelvic Pain) network study.  Urology. 2018;116:23-29. doi:10.1016/j.urology.2018.03.021PubMedGoogle ScholarCrossref
4.
Han  E, Nguyen  L, Sirls  L, Peters  K.  Current best practice management of interstitial cystitis/bladder pain syndrome.  Ther Adv Urol. 2018;10(7):197-211. doi:10.1177/1756287218761574PubMedGoogle ScholarCrossref
5.
FitzGerald  MP, Payne  CK, Lukacz  ES,  et al; Interstitial Cystitis Collaborative Research Network.  Randomized multicenter clinical trial of myofascial physical therapy in women with interstitial cystitis/painful bladder syndrome and pelvic floor tenderness.  J Urol. 2012;187(6):2113-2118. doi:10.1016/j.juro.2012.01.123PubMedGoogle ScholarCrossref
6.
Verghese  TS, Riordain  RN, Champaneria  R, Latthe  PM.  Complementary therapies for bladder pain syndrome: a systematic review.  Int Urogynecol J. 2016;27(8):1127-1136. doi:10.1007/s00192-015-2886-3PubMedGoogle ScholarCrossref
7.
Zhang  W, Deng  X, Liu  C, Wang  X.  Intravesical treatment for interstitial cystitis/painful bladder syndrome: a network meta-analysis.  Int Urogynecol J. 2017;28(4):515-525. doi:10.1007/s00192-016-3079-4PubMedGoogle ScholarCrossref
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