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May 2012: Painful Bladder Syndrome

30 Apr 2012

Bruce A Rosenzweig, M.D., is a board-certified, fellowship-trained urogynecologist at Vanguard Weiss Memorial Hospital. His areas of expertise include pelvic organ prolapse, chronic pelvic pain, interstitial cystitis, pessary use, pelvic floor rehabilitation and surgical management of urinary incontinence.

Bruce A. Rosenzweig, M.D.
Director of Urogynecology
Vanguard Medical Group
Vanguard Weiss Memorial Hospital
(773) 564-6025

Urinary tract infections (UTIs) are an infrequent occurrence during a woman’s life. However, if UTIs occur more than three times a year, or if symptoms persist after the infection has been treated, this could be a sign of a painful bladder.

Painful Bladder Syndrome
Symptoms of acute urinary tract infections include pain with urination, pelvic pain and frequent or urgent urination. Treatment is a short course of antibiotics. If these symptoms recur shortly after therapy or persist even with therapy, it may be a sign of a different diagnosis, namely Painful Bladder Syndrome.

Painful Bladder Syndrome (PBS) is a condition associated with a chronic irritation of the bladder. It may have started with a UTI or a bladder catheter from a surgical procedure or delivery, but it can occur without a recognized precipitating factor. With PBS, a woman suffers with  persistent pain below the pubic bone or lower back as the bladder fills or with urination. The pain may be felt in the urethra or vagina. She may also experience a frequent or urgent need to urinate; there may also be blood in the urine. Many times these symptoms are attributed to a UTI. But if the symptoms persist after antibiotic therapy is completed, the diagnosis is more likely PBS.

Many times women with PBS have other chronic pain conditions such as endometriosis, irritable bowel syndrome or fibromyalgia. They also may have autoimmune conditions such as rheumatoid arthritis or lupus. Women with PBS often need to see a specialist for evaluation and treatment. Treatment is usually medications but other adjuvant therapies can be helpful.

Next steps
Urinary tract infections can be a  common malady; however, if the symptoms recur or persist, the underlying cause should be identified and diagnosed by a doctor with special interests in bladder problems.

Follow these guidelines to minimize symptoms while waiting to see a doctor:

  • Avoid bladder irritants such as caffeine (coffee, soda and most teas), alcohol, spicy foods, acidic foods and beverages.
  • Urinate more frequently than the pain episodes or the urge to go. Do not wait more than three hours between voiding.
  • Avoid precipitating factors such as stress, sexual contact or swings in hormones.
  • Try soothing events such as warm baths, heating pads, yoga or meditation.

For more information
If you would like more information about painful bladder syndrome or other women’s health issues, or would like an appointment, please call Dr. Rosenzweig’s office at (773) 564-6025.