Pain in Women pp 173-188 | Cite as

Painful Bladder Syndrome/Interstitial Cystitis in Women

  • Leah Moynihan
  • Eman Elkadry


Painful bladder syndrome affects thousands, if not millions, of women. However, the syndrome is not completely understood and is often incorrectly diagnosed. Despite ongoing research, there is a lack of effective treatments and understanding of the pathogenesis of chronic pelvic and bladder pain syndromes. This condition can occur in men as well, although symptoms are often blamed on chronic prostatitis.


Pelvic Floor Chronic Fatigue Syndrome Pelvic Floor Muscle Interstitial Cystitis Pelvic Pain Syndrome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Abrams P, Cardozo L, Fall M, Standardization Sub-committee of the International Continence Society, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002;21(2):167–78.PubMedCrossRefGoogle Scholar
  2. 2.
    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(1):60–7.PubMedCrossRefGoogle Scholar
  3. 3.
    Hanno P, Lin A, Nordling J, Nyberg L, van Ophoven A, Ueda T, Wein A, Bladder Pain Syndrome Committee of the International Consultation on Incontinence. Bladder Pain Syndrome Committee of the International Consultation on Incontinence. Neurourol Urodyn. 2010;29(1):191–8.PubMedCrossRefGoogle Scholar
  4. 4.
    Rovner E, Propert KJ, Brensinger C, et al. Treatments used in women with interstitial cystitis: the interstitial cystitis data base study experience. The Interstitial Cystitis Data Base Study Group. Urology. 2000;20(56):940.CrossRefGoogle Scholar
  5. 5.
    Simon LJ, Landis JR, Erickson DR, Nyberg LM. The interstitial Cystitis Data Base Study: concepts and preliminary baseline descriptive statistics. Urology. 1997;49:64.PubMedCrossRefGoogle Scholar
  6. 6.
    Koziol JA. Epidemiology of interstitial cystitis. Urol Clin North Am. 1994;21(1):7–20.PubMedGoogle Scholar
  7. 7.
    Alagiri M, Chottiner S, Ratner V, Slade D, Hanno PM. Interstitial cystitis: unexplained associations with other chronic disease and pain syndromes. Urology. 1997;49(5A Suppl):52–7.PubMedCrossRefGoogle Scholar
  8. 8.
    Weiss JM. Pelvic floor myofascial trigger points: manual therapy for interstitial cystitis and the urgency-frequency syndrome. J Urol. 2001;166:2226.PubMedCrossRefGoogle Scholar
  9. 9.
    Peters KM, Kalinowski SE, Carrico DJ. Fact or fiction – is abuse prevalent in patients with interstitial cystitis? Results from a community survey and clinic population. J Urol. 2007;178:891.PubMedCrossRefGoogle Scholar
  10. 10.
    Lilius HG, Oravisto KJ, Valtonen EJ. Origin of pain in interstitial cystitis. Effect of ultrasound treatment on the concomitant levator ani spasm syndrome. Scand J Urol Nephrol. 1973;7:15.CrossRefGoogle Scholar
  11. 11.
    Oyama IA, Rejba A, Lukban JC, et al. Modified Thiele massage as therapeutic intervention for female patients with interstitial cystitis and high-tone pelvic floor dysfunction. Urology. 2004;64:862.PubMedCrossRefGoogle Scholar
  12. 12.
    Mayson BE, Teichman JM. The relationship between sexual abuse and interstitial cystitis/painful bladder syndrome. Curr Urol Rep. 2009;10:441.PubMedCrossRefGoogle Scholar
  13. 13.
    Aloisi AM, Buonocore M, Merlo L, Galandra C, Sotgiu A, Bacchella L, Ungaretti M, Demartini L, Bonezzi C. Chronic pain therapy and hypothalamic-pituitary-adrenal axis impairment. Psychoneuroendocrinology. 2011;36(7):1032–9.PubMedCrossRefGoogle Scholar
  14. 14.
    Dimitrakov J, Guthrie D. Genetics and phenotyping of urological chronic pelvic pain syndrome. J Urol. 2009;181:1550.PubMedCrossRefGoogle Scholar
  15. 15.
    Talati A, Ponniah K, Strug LJ. Panic disorder, social anxiety disorder, and a possible medical syndrome previously linked to chromosome 13. Biol Psychiatry. 2008;63:594.PubMedCrossRefGoogle Scholar
  16. 16.
    Wright LJ, Noonan C, Ahumada S. Psychological distress in twins with urological symptoms. Gen Hosp Psychiatry. 2010;32:262.PubMedCrossRefGoogle Scholar
  17. 17.
    Peters KM, Killinger KA, Ibrahim IA. Childhood symptoms and events in women with interstitial cystitis/painful bladder syndrome. Urology. 2009;73:258.PubMedCrossRefGoogle Scholar
  18. 18.
    Shorter B, Lesser M, Moldwin RM, Kushner L. Effect of comestibles on symptoms of interstitial cystitis. J Urol. 2007;178(1):145–52.PubMedCrossRefGoogle Scholar
  19. 19.
    Rothrock NE, Lutgendorf SK, Kreder KJ, et al. Stress and symptoms in patients with interstitial cystitis: a life stress model. Urology. 2001;57:422.PubMedCrossRefGoogle Scholar
  20. 20.
    Whitmore KE. Complementary and alternative therapies as treatment approaches for interstitial cystitis. Rev Urol. 2002;4 Suppl 1:S28–35.PubMedGoogle Scholar
  21. 21.
    Kushner L, Moldwin RM. Efficiency of questionnaires used to screen for interstitial cystitis. J Urol. 2006;176(2):587–92.PubMedCrossRefGoogle Scholar
  22. 22.
    Forrest JB, Moldwin R. Diagnostic options for early identification and management of interstitial cystitis/painful bladder syndrome. Int J Clin Pract. 2008;62(12):1926–34.PubMedCrossRefGoogle Scholar
  23. 23.
    Waxman JA, Sulak PJ, Kuehl TJ. Cystoscopic findings consistent with interstitial cystitis in normal women undergoing tubal ligation. J Urol. 1998;160:1663.PubMedCrossRefGoogle Scholar
  24. 24.
    Denson MA, Griebling TL, Cohen MB, Kreder KJ. Comparison of cystoscopic and histological findings in patients with suspected interstitial cystitis. J Urol. 2000;164:1908.PubMedCrossRefGoogle Scholar
  25. 25.
    Ottem DP, Teichman JM. What is the value of cystoscopy with hydrodistension for interstitial cystitis? Urology. 2005;66(3):494–9.PubMedCrossRefGoogle Scholar
  26. 26.
    Fitzgerald MP, Anderson RU, Potts J, et al. Randomized multicenter feasibility trial of myofascial physical therapy for the treatment of urological chronic pelvic pain syndromes. J Urol. 2009;182(2):570–80.PubMedCrossRefGoogle Scholar
  27. 27.
    Chaiken DC, Blaivas JG, Blaivas ST. Behavioral therapy for the treatment of refractory interstitial cystitis. J Urol. 1993;149(6):1445.PubMedGoogle Scholar
  28. 28.
    Fuentes CJP, Armijo-Olivo S, Magee DJ, Gross DP. Effects of exercise therapy on endogenous pain-relieving peptides in musculoskeletal pain: a systematic review. Clin J Pain. 2011;27(4):365–74.CrossRefGoogle Scholar
  29. 29.
    Dubin R, King-VanVlack C. The trajectory of chronic pain: can a community-based exercise/education program soften the ride? Pain Res Manag. 2010;15(6):361–8.PubMedGoogle Scholar
  30. 30.
    Dimitrakov J, Kroenke K, Steers WD. Pharmacologic management of painful bladder syndrome/interstitial cystitis: a systematic review. Arch Intern Med. 2007;167(18):1922.PubMedCrossRefGoogle Scholar
  31. 31.
    Davis EL, El Khoudary SL, Talbott EO. Safety and efficacy of the use of intravesical and oral pentosan polysulfate sodium for interstitial cystitis: a randomized double-blind clinical trial. J Urol. 2008;179(1):177–85.PubMedCrossRefGoogle Scholar
  32. 32.
    Leite FM, Atallah AN, El Dib R, Grossmann E, Januzzi E, Andriolo RB, da Silva EM. Cyclobenzaprine for the treatment of myofascial pain in adults. Cochrane Database Syst Rev. 2009;8(3):CD006830.Google Scholar
  33. 33.
    Nickel JC, Payne CK, Forrest J, et al. The relationship among symptoms, sleep disturbances and quality of life in patients with interstitial cystitis. J Urol. 2009;181(6):2555–61.PubMedCrossRefGoogle Scholar
  34. 34.
    Sasaki K, Smith CP, Chuang YC, et al. Oral gabapentin (neurontin) treatment of refractory genitourinary tract pain. Tech Urol. 2001;7(1):47–9.PubMedGoogle Scholar
  35. 35.
    Phatak S, Foster Jr HE. The management of interstitial cystitis: an update. Nat Clin Pract Urol. 2006;3(1):45–53.PubMedCrossRefGoogle Scholar
  36. 36.
    Foster Jr HE, Hanno PM, Nickel JC, Interstitial Cystitis Collaborative Research Network, et al. Effect of amitriptyline on symptoms in treatment naïve patients with interstitial cystitis/painful bladder syndrome. J Urol. 2010;183(5):1853–8.PubMedCrossRefGoogle Scholar
  37. 37.
    Sant GR, Propert KJ, Hanno PM, et al. A pilot clinical trial of oral pentosan polysulfate and oral hydroxyzine in patients with interstitial cystitis. J Urol. 2003;170(3):810–5.PubMedCrossRefGoogle Scholar
  38. 38.
    Seshadri P, Emerson L, Morales A. Cimetidine in the treatment of interstitial cystitis. Urology. 1994;44(4):614–6.PubMedCrossRefGoogle Scholar
  39. 39.
    Thilagarajah R, Witherow RO, Walker MM. Oral cimetidine gives effective symptom relief in painful bladder disease: a prospective, randomized, double-blind placebo-controlled trial. BJU Int. 2001;87(3):207–12.PubMedCrossRefGoogle Scholar
  40. 40.
    Nickel JC, Moldwin R, Lee S, et al. Intravesical alkalinized lidocaine (PSD597) offers sustained relief from symptoms of interstitial cystitis and painful bladder syndrome. BJU Int. 2009;103(7):910–8.PubMedCrossRefGoogle Scholar
  41. 41.
    Parsons CL. Successful downregulation of bladder sensory nerves with combination of heparin and alkalinized lidocaine in patients with interstitial cystitis. Urology. 2005;65:45.PubMedCrossRefGoogle Scholar
  42. 42.
    Moldwin RM, Evans RJ, Stanford EJ, Rosenberg MT. Rational approaches to the treatment of patients with interstitial cystitis. Urology. 2007;69(4 Suppl):73–81.PubMedCrossRefGoogle Scholar
  43. 43.
    Dawson TE, Jamison J. Intravesical treatments for painful bladder syndrome/interstitial cystitis. Cochrane Database Syst Rev. 2007;17(4):CD006113.Google Scholar
  44. 44.
    Dmochowski R, Chapple C, Nitti VW, et al. Efficacy and safety of onabotulinumtoxinA for idiopathic overactive bladder: a double-blind, placebo controlled, randomized, dose ranging trial. J Urol. 2010;184:2416.PubMedCrossRefGoogle Scholar
  45. 45.
    Smith CP, Radziszewski P, Borkowski A, et al. Botulinum toxin A has antinociceptive effects in treating interstitial cystitis. Urology. 2004;64:871.PubMedCrossRefGoogle Scholar
  46. 46.
    Anger JT, Weinberg A, Suttorp MJ, et al. Outcomes of intravesical botulinum toxin for idiopathic overactive bladder symptoms: a systematic review of the literature. J Urol. 2010;183:2258.PubMedCrossRefGoogle Scholar
  47. 47.
    Zhao J, Nordling J. Posterior tibial nerve stimulation in patients with intractable interstitial cystitis. BJU Int. 2004;94(1):101–4.PubMedCrossRefGoogle Scholar
  48. 48.
    Zhao, J, Bai J, Zhou Y, Qi G, Du L. Posterior tibial nerve stimulation twice a week in patients with interstitial cystitis. Urology. 2008;71(6):1080–4.PubMedCrossRefGoogle Scholar
  49. 49.
    Paszkiewicz EJ, Siegel SW, Kirkpatrick C, Hinkel B, Keeisha J, Kirkemo A. Sacral nerve stimulation in patients with chronic, intractable pelvic pain. Urology. 2001 Jun;57(6 Suppl 1):124.PubMedCrossRefGoogle Scholar
  50. 50.
    Maher CF, Carey MP, Dwyer PL, Schluter PL. Percutaneous sacral nerve root neuromodulation for intractable interstitial cystitis. 2001;165(3):884–6.PubMedCrossRefGoogle Scholar
  51. 51.
    Hwang P, Auclair B, Beechinor D, et al. Efficacy of pentosan polysulfate in the treatment of interstitial cystitis: a meta-analysis. Urology. 1997;50(1):39.PubMedCrossRefGoogle Scholar
  52. 52.
    Nickel JC, Barkin J, Forrest J. Randomized, double-blind, dose-ranging study of pentosan polysulfate sodium for interstitial cystitis. Urology. 2005;65(4):654–8.PubMedGoogle Scholar
  53. 53.
    Hohenfellner Surgical treatment. 1997 In Sant: Interstitial cystitis.Google Scholar
  54. 54.
    Goldstein HB, Safaeian P, Garrod K, et al. Depression, abuse and its relationship to interstitial cystitis. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(12):1683–6.PubMedGoogle Scholar
  55. 55.
    Carrico DJ, Peters KM, Diokno AC. Guided imagery for women with interstitial cystitis: results of a prospective, randomized controlled pilot study. J Altern Complement Med. 2008;14(1):53–60.PubMedGoogle Scholar
  56. 56.
    Rapkin AJ, Kames LD. The pain management approach to chronic pelvic pain. J Reprod Med. 1987;32(5):323–7.PubMedGoogle Scholar
  57. 57.
    Karper WB. Exercise effects on interstitial cystitis: two case reports. Urol Nurs. 2004;24:202.PubMedGoogle Scholar
  58. 58.
    Ripoll E, Mahowald D. Hatha yoga therapy management of urologic disorders. World J Urol. 2002;20:306.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Leah Moynihan
    • 1
  • Eman Elkadry
    • 2
  1. 1.Boston Urogynecology AssociatesBostonUSA
  2. 2.Mount Auburn HospitalHarvard University School of MedicineCambridgeUSA

Personalised recommendations