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Painful Bladder Syndrome

In urogynaecology, there is a specific condition of the bladder that can cause extreme urgency and frequency, that is often associated with pain, and is termed painful bladder syndrome or interstitial cystitis.

The most significant symptom is that of pain either in the lower abdomen, region above the pubis, perineum, lower back, vulva & vagina in the women, associated with the filling and deflating of the bladder (in the absence of any infection).

This poorly understood disease is surprisingly common amongst women in their 40’s to 50’s (with a female to male ratio of 9:1); and is believed to be a defect in the water-proof layer (called a GAG layer) of the skin lining within the bladder, possibly with immune and nerve-related components to the disease process. What has been elucidated from studies is that there is a lack of chondriotin sulphate and other components in the GAG layer, causing noxious substances to cross into the bladder tissues and trigger off pain nerve fibres.

The diagnosis of PBS/IC is typically based on a comprehensive history and examination, with a diagnostic cystoscopy and biopsies if PBS/IC is strongly suspected. Once a diagnosis is made, the treatment is multi-pronged; involving pain relief and control, re-establishing the GAG layer and controlling urinary symptoms, thus allowing a patient to reclaim their life back and improve their quality of life.

Some patients complain of worsening PBS/IC symptoms upon consuming certain types of food (such as oranges, tomatoes and other acidic foodstuffs). A change in diet appears to significantly reduce unpleasant symptoms.

In certain cases, using a device that changes the nerve response, electrical neuro-modulation, appears to help in very severe recalcitrant cases of PBS/IC

In conclusion, PBS/IC is a difficult and debilitating disorder that requires patience, kindness, understanding and time from all parties involved, and family support is paramount in such cases.