Overview of Bladder Pain Syndrome presentation
Bladder Pain Syndrome presents in many different ways. Each patient experiences the syndrome differently, with the severity of the symptoms and the effect that they have on the patient physically, psychologically and socially being extremely diverse.
Bladder Pain Syndrome (BPS) Patient Treatment Pathway
Bladder Pain Syndrome has been proposed to be diagnosed on the following symptoms:
Chronic (>6 months) pelvic pain, pressure or discomfort- perceived to be related to the urinary bladder.1
Accompanied by at least one other urinary symptom
- Urgency
- Frequency
- Pain on urination
Patients often present with considerable distress, partly from the symptoms themselves, but also due to the significant effect the syndrome can have on work, social and physical relationships.
Common investigations for BPS
Physical and Neurological Examination
These are undertaken to exclude an alternate cause of the patient’s symptoms. In women, this will involve examination of the abdomen, pelvis, vagina and rectum. In men, the abdomen, prostate and rectum will be examined.
Pain Assessment and Bladder Diary
Questionnaires are commonly used to measure the baseline level of the patient’s pain, and to elicit exacerbating and relieving factors. A bladder diary recording both the volume of urine passed and urinary frequency aids in the assessment of bladder function.
Voiding Tests
Commonly a voiding cystourethrogram is performed. This allows measurement of the bladder volume at the onset of symptoms, intravesical pressures and the residual volume after voiding.
Cystoscopy
Cystoscopies can be performed under local or general anaesthetic. They will allow the exclusion of other causes of symptoms (for example bladder stones), allow visualisation of glomerulations or Hunner’s lesions, and will facilitate biopsies if necessary.
1. van de Merwe JP, Nordling J, Bouchelouche P, et al. Diagnostic Criteria, Classification, and Nomenclature for Painful Bladder Syndrome/Interstitial Cystitis: An ESSIC Proposal. Eur Urol 2008;53:60-7
Date of preparation: April 2024 | UK-URO-146ba(1)