Sites of Pain From Interstitial Cystitis/Painful Bladder Syndrome

Abstract

Suprapubic prominence and changes in the voiding cycle are features consistent with but do not prove that the bladder is the pain generator in interstitial cystitis/painful bladder syndrome and the pain sites described by patients are referred from it. The patients with interstitial cystitis/painful bladder syndrome who might have been diagnosed with vulvodynia or urethral syndrome did not differ from others in important patient variables.

Is Urethral Pain Syndrome Really Part of Bladder Pain Syndrome?

“…In terms of pain, suprapubic or bladder pain is prominent. However, many patients report different and/or additional sites, particularly in the urethra, genitalia, and lower back [27,28]. Although the cause of BPS is usually unknown, there is a body of evidence supporting the involvement of bladder urothelial abnormalities in these illnesses [29,30].…”

Advances in Diagnosis and Treatment of Interstitial Cystitis/Painful Bladder Syndrome

“…Patients often report suprapubic pain related to the bladder filling, as well as at other sites such as the urethra, vulva, vagina, rectum, and extragenital sites such as the lower abdomen and back [23]. Additionally, patients frequently report pain in almost all body areas as mapping patterns of body pain in 193 patients showed that 73 % of IC/BPS patients reported pain outside the primary IC/BPS site (i.e., vagina, lower abdomen, lower back, pelvis, and buttocks) [24].…”

Urologic Chronic Pelvic Pain Syndrome

“…Many patients will report pain that changes locations and occurs in multiple sites. 7 Irritative voiding symptoms (urgency, increased frequency, nocturia, dysuria) and dyspareunia are common, and 84% to 90% of patients with PBS report worsening of pain with bladder filling. 3,23 Burning and pain during urination occurs in 69% of patients.…”

“…Most women note that pain is worsened by touching, tampons, and intercourse. Some have worsening with urination or while riding in a car, 7 and some women report a pain flare at the time of the menstrual cycle. 24 …”

“…Active trigger points in internal and external pelvic regions that consistently reproduce specific patterns of referred pain in both men with CPPS and women with PBS have been identified. 6,7 Up to 70% of men with symptoms of nonbacterial prostatitis and prostatodynia have glomerulations and submucosal hemorrhages when undergoing bladder distention under anesthesia, raising the possibility that some cases of prostatitis may actually be IC. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) classification of prostatitis has replaced the older terms nonbacterial prostatitis and prostatodynia with category 3 chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS, or simply CPPS).…”