Mohamed Akl, MD, is a urogynecologist practicing at Banner Gateway Medical Center.
Question: Can the bladder be a missed cause of pelvic pain?
Answer: The urinary bladder is a muscular organ located in the pelvis and can be a precipitating factor for pelvic pain. Interstitial cystitis (IC) is a bladder disorder that can cause varying degrees of pelvic pain, discomfort, burning or pressure and may be associated with urinary urgency (persistent urgent need to go to the bathroom), frequency (urinating too often) and painful sexual intercourse. Although symptoms of IC may resemble those of recurring urinary tract infections, a urine test is usually free of bacteria. Symptoms can be severe enough to have significant effects on quality of life.
Current estimates indicate that IC affects 1 million Americans and is nine times more prevalent in females than males. The exact cause of IC is not fully understood; however, one of the most acceptable theories indicates that patients with IC have gaps in the protective lining of the bladder cavity which allows toxic irritants from the urine to go into the bladder wall muscle and irritate it. When IC is suspected, the patient is usually given a questionnaire focused on bladder symptoms. Other confirmatory diagnostic tests can be done at the physician’s office.
IC is a chronic disorder that cannot be totally cured; however, treatment is directed towards symptom relief to improve the patient’s quality of life. Treatment may include dietary modifications, oral medications, bladder instillations (filling the bladder with a soothing solution) and others. There is no simple single treatment that can eliminate all symptoms of IC. Patients may need to try various treatments, or combinations of them, to fully control IC symptoms. If you think you are experiencing IC symptoms, ask your primary care physician to refer you to a specialist (urogynecologist or urologist).
Reviewed April 2010