Bladder pain—also known as painful bladder syndrome—affects approximately 1 million Americans, according to the Mayo Clinic. Women suffer the most from this condition, although children and men can develop it as well. The causes of this condition are not known, therefore the goal of treatment is to alleviate the symptoms. No single treatment works for everyone, and in some cases, more than one treatment or a combination of treatments may be necessary.
Bladder Distention
A temporary improvement may be seen when patients undergo a bladder distention. During this procedure the doctor stretches the bladder with either water or gas. As the website WomensHealth.gov explains, bladder distention helps ease the pain for some patients, although it is unclear why. Patients can undergo this procedure as many times as necessary.
Bladder Instillation
When doctors perform a bladder instillation—also known as a bladder wash or bath—they insert the prescription medication, dimethyl sulfoxide, into the bladder. Once this medication has been left in for 15 minutes, the patient expels it through urination. The Mayo Clinic explains that inserting this medication directly into the bladder helps reduce swelling, and may even prevent the muscle contractions that result in urinary frequency, urgency and pain. The National Kidney and Urologic Diseases Information Clearinghouse states that patients undergo this procedure every one to two weeks for a period of six to eight weeks, and then repeat it as needed. For those who respond well to the medication, an improvement is typically seen three to four weeks after the first six- to eight-week cycle.
Electrical Nerve Stimulation
Gentle electrical impulses can stimulate the nerves to the bladder, and can be sent one of two ways: through the skin or via an implanted device.
A TENS unit—known also as transcutaneous electrical nerve stimulation—helps relieve pelvic pain and for some people, reduce urinary frequency. The Mayo Clinic explains that this system works by either increasing blood flow to the bladder, helping release the substances that block the pain, or by strengthening the muscles responsible for bladder control. The electrical impulses are sent through wires which are placed on the lower back or just above the pubic area, and the length of treatment time varies to meet the convenience of the patient. On average, the pulses are sent for minutes or hours during each session, with two sessions each day.
The other option is an implanted device known as sacral nerve stimulation. This is a surgical procedure during which the doctor implants a thin wire near the sacral nerves, which are the primary nerves between the spinal cord and the bladder, according to the Mayo Clinic. This delivers electrical impulses to the bladder. This procedure may help reduce the feelings of urgency that accompany bladder pain.
Medication
The National Kidney and Urologic Diseases Information Clearinghouse explains that the Food and Drug Administration approved a drug specifically for the treatment of bladder pain: Elmiron. Doctors do not know exactly how this drug works, however, the theory is that it may repair any defects in the lining of the bladder. During clinical trials, 30 percent of patients saw an improvement in symptoms. It may take up to four months before results are seen, and the primary side effects are minor gastrointestinal discomfort. It may also affect the liver.
Nonsteroidal anti-inflammatory drugs available over the counter, such as ibuprofen, can be taken to reduce inflammation and pain, while doctors may prescribe tricyclic antidepressants to help relax the bladder and block the pain, reports the Mayo Clinic.
