The bladder is a hollow muscular elastic organ that stores urine excreted by the kidney before it is emptied from the body by means of urination. Bladder pain can be caused by urinary tract infection (UTI), bladder cancer or interstitial cystitis, the inflammation or irritation of the bladder.
Pain varies depending on the condition. You may experience vaginal or vulvar pain, pain with intercourse or while urinating, which are characteristic symptoms of interstitial cystitis. While an infection of the urinary tract and bladder cancer can also cause painful urination, pain is felt in the abdomen for the former and in the lower back for bladder cancer. Apart from pain, some of the other common symptoms include urinary urgency and frequency, irritable bowel syndrome, foul-smelling, cloudy or bloody urine, and mild fever.
When you visit the clinic with a painful bladder, your doctor will review your history, perform a thorough physical exam and order urine analysis, a cystoscopy (a lighted tube may be used to view the bladder for abnormalities) and imaging tests to diagnose the cause of pain. A thorough physical examination and cystoscopy is critical to the diagnosis of interstitial cystitis. Urine analysis helps rule out other conditions and confirm a urinary tract infection. A biopsy can be performed during the cystoscopy to remove tissue samples to rule out bladder cancer. Imaging tests such as CT and MRI scans help confirm on the diagnosis.
Based on the cause of pain, your doctor will design a suitable treatment plan. The mainstay treatment for urinary tract infection is antibiotics.
Treatment of painful bladder due to interstitial cystitis involves a combination of treatments:
- Medications such as pain relievers, antihistamines, antidepressants and seizure medications
- A diet low in soda, caffeine and spicy foods, which can worsen bladder symptoms
- Physical therapy to strengthen the pelvic floor muscles and ease symptoms.
- Bladder instillations, where a mixture of several medications such as steroids and pain relievers are instilled into the bladder for immediate relief
- Cystoscopy with hydro distension, involves bladder stretching,
- Neuromodulation involves implanting a pacemaker for treating an over reactive bladder
- Injecting Botox
Treatment options for bladder cancer include surgery to remove the cancer, which can be performed alone or in combinations with other treatments. Chemotherapy (cancer-killing drugs) and radiation therapy (high-dose radiation) may be performed before or after surgery to destroy the cancer cells. Your doctor may also perform immunotherapy (using immune system) to attack and kill cancer cells.