Materiały źródłowe

• #1 Interstitial Cystitis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/15735-interstitial-cystitis-painful-bladder-syndrome

  Interstitial cystitis/bladder pain syndrome is a condition that causes long-term pain or discomfort in your bladder and abdominal area, along with urinary frequency and urgency. […] Interstitial cystitis now known as bladder pain syndrome (IC/BPS) is long-term (chronic) discomfort, pain or pressure in your bladder area (suprapubic region). […] If you have IC/BPS, you need to urinate (pee) more often than usual (frequency) and feel like you have to pee right away (urgency). […] You cant fix or cure interstitial cystitis/bladder pain syndrome. But there are many ways to treat it. The goal of IC/BPS treatment is to relieve your symptoms. A healthcare provider will work with you to decide the most appropriate treatment. […] IC/BPS treatments may include: […] Some people who have IC/BPS report that certain foods and drinks worsen their symptoms (triggers). Keep a diary or journal of what and how much you eat and drink each day.

• #2 Nursing Care of Women With Interstitial Cystitis/Painful Bladder Syndrome – PubMed

  https://pubmed.ncbi.nlm.nih.gov/27067933/

  Interstitial cystitis/painful bladder syndrome is a chronic condition affecting approximately 3.3 million women in the United States. […] Because of the intimate nature of the symptoms, women are often reluctant to seek treatment. When they do, they require a care provider with specialized nursing skills. Nursing practice based on carefully reviewed literature will result in the provision of comprehensive and compassionate nursing care for women with interstitial cystitis/painful bladder syndrome.

• #3 Patient education: Treatment of interstitial cystitis/bladder pain syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-of-interstitial-cystitis-bladder-pain-syndrome-beyond-the-basics/print

  INTERSTITIAL CYSTITIS/BLADDER PAIN SYNDROME OVERVIEW […] Interstitial cystitis/bladder pain syndrome (IC/BPS) is a disorder with symptoms of mild to severe bladder pain and an urgent and/or frequent need to urinate. Treatment of IC/BPS often depends on a clinician’s preferences and experience in treating the disorder rather than on scientific studies because the cause of this condition is not clear. […] A number of treatments are available for IC/BPS, many of which are effective for at least some patients. Most patients with IC/BPS need to try more than one treatment, sometimes in combination, to find the one(s) that provides the greatest relief. […] AVOIDING PAINFUL BLADDER FLARES […] Many people with IC/BPS have periods of time when symptoms are not bothersome that alternate with periods of time when symptoms are bothersome or even severe (called flares). It is not always clear why flares develop. However, the following triggers may worsen symptoms in some people:

• #3 Patient education: Treatment of interstitial cystitis/bladder pain syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-of-interstitial-cystitis-bladder-pain-syndrome-beyond-the-basics/print

  Activities — In some people, exercise or recreational activities (eg, riding a bicycle), sexual activity, or certain body positions (eg, prolonged sitting) can worsen bladder symptoms. Other activities such as yoga, Pilates, walking, or working at a standing desk may be less bothersome. […] Foods and beverages — If you can identify foods or drinks that aggravate bladder pain or urinary urgency or frequency, it is reasonable to avoid them during a symptom flare. However, it is not clear that these items should be avoided at other times. Some practitioners recommend a restrictive „interstitial cystitis diet,” although its benefit has not been studied. […] COPING WITH CHRONIC PAIN […] IC/BPS is not a psychologic disorder, but the symptoms can be worsened by stress, anxiety, depression, and other psychologic factors. In addition, living with pain can cause difficulties in relationships, at work or school, and with general day-to-day living. Psychosocial support can be helpful in dealing with these issues.

• #4 Bladder pain syndrome (interstitial cystitis)

  https://www.nhs.uk/conditions/interstitial-cystitis/

  Bladder pain syndrome (BPS) is a poorly understood condition where you have pelvic pain and problems peeing. […] It’s sometimes called interstitial cystitis or painful bladder syndrome. […] It’s difficult to diagnose BPS (interstitial cystitis) as there is no single test that confirms the condition. […] The main symptoms of BPS (interstitial cystitis) include intense pelvic pain (felt over your lower tummy), sudden strong urges to pee, needing to pee more often than usual, pain in your lower tummy when your bladder is filling up, which is relieved when you pee, and waking up several times during the night to pee. […] Other symptoms can include finding it difficult to pee, urinary incontinence and blood in your urine (haematuria). […] BPS (interstitial cystitis) can have similar symptoms to long-term or frequent UTIs, so the GP may give you a urine test to check for a UTI.

• #5 Interstitial cystitis – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/interstitial-cystitis/symptoms-causes/syc-20354357

  Interstitial cystitis (in-tur-STISH-ul sis-TIE-tis) is a chronic condition causing bladder pressure, bladder pain and sometimes pelvic pain. The pain ranges from mild discomfort to severe pain. The condition is a part of a spectrum of diseases known as painful bladder syndrome. […] Interstitial cystitis most often affects women and can have a long-lasting impact on quality of life. Although there’s no cure, medications and other therapies may offer relief. […] If you’re experiencing chronic bladder pain or urinary urgency and frequency, contact your health care provider. […] Interstitial cystitis can result in a number of complications, including: Reduced bladder capacity. Interstitial cystitis can cause stiffening of the bladder wall, which allows your bladder to hold less urine. […] Lower quality of life. Frequent urination and pain may interfere with social activities, work and other activities of daily life. […] Sexual intimacy problems. Frequent urination and pain may strain your personal relationships, and sexual intimacy may suffer. […] Emotional troubles. The chronic pain and interrupted sleep associated with interstitial cystitis may cause emotional stress and can lead to depression.

• #6 Bladder pain

  https://womenshealth.gov/a-z-topics/bladder-pain

  Bladder pain syndrome (also called interstitial cystitis or painful bladder syndrome) is a chronic (long-term) pain condition that affects the bladder. […] Bladder pain syndrome affects more women than men. […] Some women have severe symptoms that can lead to other health problems such as depression. […] Bladder pain syndrome may also affect your sex life. […] There is no cure, but there is treatment to help relieve your symptoms, including pain. […] Sometimes symptoms get better without treatment. […] Bladder pain syndrome can be difficult to diagnose in a woman because not every doctor agrees on the exact definition. […] Your doctor or nurse will do a physical exam to look at your lower abdomen and lower back and ask you questions about your symptoms. […] If your symptoms do not get better, other treatments your doctor may suggest include: Physical therapy. Some or all of the pain that is diagnosed as bladder pain syndrome may be caused by spasm in the pelvic floor, lower abdomen, or back muscles. A physical therapist who specializes in pelvic floor disorders can help treat the pain by teaching you strengthening and relaxation techniques.

• #7 Bladder pain

  https://womenshealth.gov/a-z-topics/bladder-pain

  Your doctor will talk to you about steps you can take at home to improve your symptoms. […] These steps may include: Reduce stress. Stress is the most common cause of symptom flare in women with bladder pain syndrome. […] Get regular physical activity. Low-impact physical activity, such as stretching, swimming, and walking, may help relieve symptoms. […] Many women with bladder pain syndrome report pain during sex. […] Talk to your doctor or nurse about different positions and lubricants you can get in the drugstore to relieve vaginal dryness during sex and ease pain.

• #8 Bladder pain syndrome (interstitial cystitis)

  https://www.nhs.uk/conditions/interstitial-cystitis/

  Standard urine tests used in GP surgeries and hospitals may not pick up all infections of the bladder. […] When you have been diagnosed by a specialist as having BPS (interstitial cystitis), there are several treatments that may help. […] No single treatment works for everyone, and there is no conclusive evidence they work. […] Tablets or capsules may be used to treat people with BPS (interstitial cystitis). […] Some medicines can also be passed directly into the bladder using a thin tube called a catheter. […] Some people may also find physiotherapy, acupuncture, talking therapies, transcutaneous electrical nerve stimulation (TENS), and pain management helpful. […] Surgery and other procedures may be recommended if you have clear abnormal areas (lesions) in your bladder or other treatments do not work. […] Things that may help improve your symptoms include reducing stress, making sure you are hydrated regularly throughout the day, keeping a food diary, and stopping smoking.

• #9 Interstitial cystitis (bladder pain syndrome) – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/297

  Interstitial cystitis (bladder pain syndrome) is a chronic, often debilitating clinical syndrome of urinary frequency, urgency, and pelvic pain. Symptoms vary with bladder filling. […] Treatment approach is aimed at symptom relief and pain management, with minimally invasive options tried before progressing to more complex, invasive therapies. […] IC/BPS is a diagnosis of exclusion, so other common disease processes must first be excluded before effective treatment can be initiated.

• #10 Interstitial cystitis: Simplified diagnosis and treatment

  https://www.contemporaryobgyn.net/view/interstitial-cystitis-simplified-diagnosis-and-treatment

  Interstitial cystitis/bladder pain syndrome (IC/BPS) is now recognized as a common etiology in women with chronic pelvic pain. […] Most patients with IC/BPS can be treated using efficient office-based algorithms to achieve significant relief of their symptoms. […] Diagnosing and establishing a treatment plan, however, can be daunting for practitioners inexperienced in treating patients with IC/BPS. […] Efficient diagnosis and effective treatment for IC are explored and reviewed here. […] Patients with frequent symptoms of urinary tract infection (UTI) but repeated negative cultures should be evaluated for IC. It is also important to consider screening all patients presenting with subacute or chronic pelvic pain for IC. […] Two validated screening tools are available, the Pelvic Pain and Urgency/Frequency (PUF) patient symptom scale and the OLeary-Sant IC symptom and problem index.

• #11 Interstitial cystitis: Simplified diagnosis and treatment

  https://www.contemporaryobgyn.net/view/interstitial-cystitis-simplified-diagnosis-and-treatment

  These short questionnaires can be administered to patients on intake. Higher screening scores correlate most closely with the diagnosis of IC. […] The practitioner should inquire about a history of recurrent bladder infections. […] The pelvic exam can also provide clues to the diagnosis of IC. […] Bladder base tenderness and/or bilateral levator tenderness (ie, pelvic floor dysfunction) is common in patients with IC. […] Anesthetic blocks, although not actually a direct treatment for IC, can be very helpful for patients with focal muscle findings. […] Improvement in symptoms from nerve blocks would suggest an alternative diagnosis, as IC is often a diagnosis of exclusion. […] Following initial multimodal therapy, a follow-up visit should be scheduled to discuss continuing therapy.

• #12 Interstitial cystitis/painful bladder syndrome: the influence of modern diagnostic criteria on epidemiology and on Internet search activity by the public – Davis – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/6804/html

  Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic debilitating condition that is characterised by suprapubic pain and urinary symptoms such as urgency, nocturia and urinary frequency. […] Diagnosis for IC/PBS is often difficult and delayed as its presentation is similar to a number of other urological and gynaecological conditions. […] Clinicians should familiarise themselves with its evolving epidemiology, increasing prevalence and appropriate evidence based treatment options to maximise treatment outcomes early in the course of the disease. […] The updated 2011 AUA guidelines also describe more inclusive criteria for the diagnosis of IC/PBS with the aim of improving early diagnosis and treatment. […] During clinical work-up, the OLeary-Sant interstitial cystitis questionnaire contributes to the diagnostic process as it objectively defines the extent and duration of pelvic pain as well as urinary urgency and frequency.

• #13 Interstitial cystitis/painful bladder syndrome: the influence of modern diagnostic criteria on epidemiology and on Internet search activity by the public – Davis – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/6804/html

  Clinical examination is essential to exclude urogynaecological pathologies such as urethral diverticulae, vulvitis and vaginitis. […] Patients with IC/PBS are typically tender at the bladder base. […] The broadened diagnostic criteria and increased prevalence by inclusion of patients hitherto can be considered positive. From the patients viewpoint, they have a diagnostic label for their troublesome symptomatology. From a scientific viewpoint, it facilitates research on a much larger patient cohort.

• #14 Cystitis Nursing Care Plan & Management

  https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/cystitis/

  Interstitial cystitis (IC), also known as painful bladder syndrome, is a chronic condition characterized by bladder pressure, bladder pain, and sometimes pelvic pain, along with a range of urinary symptoms. […] The key diagnostic procedure for interstitial cystitis is cystoscopy with hydrodistention. […] Interstitial cystitis affects the layers of tissues in the bladder wall. Normally, these tissues protect the bladder from the toxic effects of urine. In interstitial cystitis, these protective layers are damaged, leading to inflammation and the symptoms associated with the condition. […] The exact cause of interstitial cystitis (IC), also known as painful bladder syndrome, remains currently unknown. This condition is characterized by chronic bladder pain, pressure, discomfort, and urinary symptoms such as urgency and frequency.

• #15 Patient education: Treatment of interstitial cystitis/bladder pain syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-of-interstitial-cystitis-bladder-pain-syndrome-beyond-the-basics/print

  CYSTOSCOPY […] Your clinician may perform cystoscopy (examination of the bladder with a thin telescope that goes into the bladder through the urethra). This can identify possible causes for the bladder symptoms. Some patients with IC/BPS have bladder lesions called Hunner lesions. If these lesions are seen, they can be treated during the cystoscopy, and this usually causes the IC/BPS symptoms to improve. […] Cystoscopy with hydrodistention — Cystoscopy can be combined with hydrodistention (stretching the bladder to its maximum capacity, using a liquid) while the patient is asleep. This stretching of the bladder can sometimes cause temporary improvement in the IC/BPS symptoms. […] BLADDER INSTILLATIONS […] Dimethylsulfoxide — Dimethylsulfoxide (DMSO) is a liquid medication that has been approved by the US Food and Drug Administration to treat IC/BPS. DMSO is put into the bladder through a temporary catheter and is held in place for approximately 20 minutes, if possible. These treatments are often given weekly, for six to eight weeks or longer. DMSO can temporarily cause worsened bladder pain, and it is not effective in all patients. It has been used for many years and is considered to be very safe, with no known long-term side effects.

• #16 Cystitis Nursing Care and Management: Study Guide

  https://nurseslabs.com/cystitis/

  Nursing care of patient with cystitis focuses on treating the underlying infection and preventing its recurrence. […] The following are assessed in a patient with cystitis: The presence of pain, frequency, urgency, hesitancy, and changes in the urine are assessed, documented, and reported. […] Based on the assessment data, the nursing diagnoses may include the following: Acute pain related to infection within the urinary tract. […] Major goals for the patient may include: Relief of pain and discomfort. […] The care plan should include religious patient teaching, supportive measures, and proper specimen collection. […] Expected patient outcomes include: Relief of pain and discomfort. […] The nurse should help the patient learn about and prevent or manage recurrent cystitis. […] The focus of documentation in a patient with cystitis include: Clients description of the response to pain.

• #17 Cystitis Nursing Care Plan & Management

  https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/cystitis/

  The goals of the patient may include relief of pain and discomfort, increased knowledge of preventive measures and treatment modalities, and absence of complications. […] The nurse teaches the patient health-related behaviors that help prevent recurrent UTIs, including practicing careful personal hygiene, increasing fluid intake to promote voiding and dilution of urine, urinating regularly and more frequently, and adhering to the therapeutic regimen.

• #18 Diagnosis and Treatment of Interstitial Cystitis/Bladder Pain Syndrome (2022) – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/diagnosis-and-treatment-interstitial-of-cystitis/bladder-pain-syndrome-(2022)

  The IC/BPS diagnosis should be reconsidered if no improvement occurs after multiple treatment approaches. […] Patients should be educated about normal bladder function, what is known and not known about IC/BPS, the benefits versus risks/burdens of the available treatment alternatives, the fact that no single treatment has been found effective for the majority of patients, and the fact that acceptable symptom control may require trials of multiple therapeutic options (including combination therapy) before it is achieved. […] Appropriate manual physical therapy techniques (e.g., maneuvers that resolve pelvic, abdominal and/or hip muscular trigger points, lengthen muscle contractures, and release painful scars and other connective tissue restrictions), if appropriately trained clinicians are available, should be offered to patients who present with pelvic floor tenderness. Pelvic floor strengthening exercises (e.g., Kegel exercises) should be avoided.

• #18 Diagnosis and Treatment of Interstitial Cystitis/Bladder Pain Syndrome (2022) – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/diagnosis-and-treatment-interstitial-of-cystitis/bladder-pain-syndrome-(2022)

  The purpose of this clinical guideline is to provide a clinical framework for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome (IC/BPS), including discussion of treatments that should and should not be offered. […] The purpose of this Guideline is to provide a clinical framework for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome. […] Treatment decisions should typically be made after shared decision-making, with the patient informed of the risks, potential benefits, and alternatives. Except for patients with Hunner lesions, initial treatment should be nonsurgical. […] Multimodal pain management approaches (e.g., pharmacological, stress management, manual physical therapy if available) should be initiated. Pain management should be continually assessed for effectiveness because of its importance to quality of life. If pain management is inadequate, then consideration should be given to a multidisciplinary approach and the patient referred appropriately.

• #19 What Patients Need to Manage Interstitial Cystitis: Education | Inspira Health

  https://www.inspirahealthnetwork.org/news/provider-inspiration/what-patients-need-manage-interstitial-cystitis-education

  Diagnosing interstitial cystitis/painful bladder syndrome (IC/PBS) can be complex. IC/PBS which affects 3 to 8 million women in the United States is a chronic condition that includes unpleasant sensations (discomfort, pain or pressure) that patients perceive originate from the bladder. An IC/PBS diagnosis can be made after a specialist determines symptoms have lasted for more than six weeks when there are no other identifiable causes, such as a urinary tract infection. […] Waiting for a diagnosis can be stressful, and painful, for many patients. But providers can change the narrative around IC/PBS by having educational, evidence-based conversations with patients regularly. […] When it comes to diagnosing interstitial cystitis, the first step is to obtain a complete and thorough assessment, said Woojin Chong, M.D., a urogynecologist at Inspira Medical Centers Vineland and Mullica Hill. If the patients history, physical and pain evaluation confirm their condition, then helping patients find relief from interstitial cystitis requires a step-up approach: starting with the least invasive treatment to more invasive treatment options.

• #20 What Patients Need to Manage Interstitial Cystitis: Education | Inspira Health

  https://www.inspirahealthnetwork.org/news/provider-inspiration/what-patients-need-manage-interstitial-cystitis-education

  Treatment for IC/PBS may include: Patient education and behavioral modifications, including avoiding bladder irritants and reducing stress. […] Educating patients about their condition allows you to set proper expectations. IC/PBS isn’t like a broken bone – there is no one treatment to take away the pain completely, said Dr. Chong. Because the bladder is an extremely sensitive organ and anything we eat or drink can irritate it, taking a conservative approach first can often lead to more immediate relief. […] If those changes do not alter the patients condition, move on to the next steps, said Dr. Chong. That includes seeking physical therapy, pain management and medical therapy. […] Another component in treating IC/PBS is medication, some of which is offered orally or through bladder instillation. Currently, there is only one FDA-approved oral medication for IC/PBS, but it has a slim success rate of about 30-50 percent.

• #21 Interstitial Cystitis Treatment & Management: Approach Considerations, Behavioral Therapy, Dietary Therapy

  https://emedicine.medscape.com/article/2055505-treatment

  The difficulty in treating interstitial cystitis (interstitial cystitis/bladder pain syndrome [IC/BPS]) begins in the primary care office. An integral part of therapy for interstitial cystitis is extensive patient education regarding the chronic nature of the disease and realistic assessments of the condition, prognosis, and potential responses to therapy. Ongoing reassurance and physical and emotional support are important as the diagnostic evaluation progresses and therapies are applied. […] Only rarely will patients with interstitial cystitis have an immediate, complete, and durable response to any particular therapy. They must be counseled at length regarding the lack of universally effective therapies. Often, referral to one of the local interstitial cystitis support groups, especially a local chapter of the Interstitial Cystitis Association, can be helpful in providing a continuing network of support for the patient.

• #22 Interstitial Cystitis(IC)/Bladder Pain Syndrome | University of Michigan Health

  https://www.uofmhealth.org/conditions-treatments/adult-urology/interstitial-cystitisic-bladder-pain-syndrome

  Interstitial cystitis (IC)/bladder pain syndrome (BPS) is a chronic bladder health issue. It is a feeling of pain and pressure in the bladder area. […] The symptoms of IC/BPS vary for each patient, but the most common sign is pain (often with pressure). Patients with IC/BPS may have bladder pain that gets worse as the bladder fills. […] IC/BPS can get in the way of your social life, exercise and sleep, and can cause a great deal of distress. Without treatment, IC/BPS symptoms make it hard to get through your day or even be able to work. […] No single treatment works for all people with IC/BPS. Treatment must be chosen for each patient based on symptoms. […] Lifestyle changes, known as „behavioral therapy,” are often the first treatments used to manage IC/BPS. […] Patients with IC/BPS often have tenderness and/or pain in the pelvic floor area, and sometime manipulative physical therapy can reduce symptoms.

• #23 Bladder Pain Syndrome (Interstitial Cystitis) | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.bladder-pain-syndrome-interstitial-cystitis.hw55613

  Bladder pain syndrome (BPS), also called interstitial cystitis, is a condition that causes pain in the bladder or pelvis. The pain can be severe. It also causes an urgent, frequent need to urinate. […] Treatment may include: Bladder training. To help your bladder get used to comfortably holding more urine, you can slowly increase the time between when you urinate during the day (not while sleeping). […] Physical therapy. A physical therapist can teach you exercises to relax the muscles in your lower belly, groin, and buttocks. You may want to look for a physical therapist who is specially trained in pelvic floor therapy. […] Your doctor will help you manage your pain, but there are also things you can do. Here are some ideas: Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine. […] Try bladder training. Set certain times to go to the bathroom and slowly increase the time between visits. This may help lengthen the time your bladder can hold urine. […] Talk to a counselor. Look for one who has had training in managing chronic pain.

• #24

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=zc1111

  Bladder pain syndrome (BPS), also called interstitial cystitis, is a condition that causes bladder pain. The pain can be severe. It also causes an urgent, frequent need to urinate. The pain and other symptoms can make it hard for a person to function and have a good quality of life. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] Take your medicines exactly as prescribed. Call your doctor or nurse advice line if you think you are having a problem with your medicine. […] Avoid eating spicy foods or high-acid foods, such as tomatoes and oranges, if these foods seem to make your pain worse. Also, limit caffeine and alcohol.

• #25

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=zc1111

  If a certain food seems to cause pain in your bladder, stop eating it to see if the pain goes away. […] See if using heat or cold helps relieve pain. This could be a warm bath, a heating pad, or an ice pack. […] Find ways to relax and lower your stress, such as listening to restful music, having a massage, or meditating. […] Do not smoke. Smoking can irritate the bladder and cause bladder cancer. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good. […] Try bladder training. Set certain times to use the toilet and slowly increase the time between visits. This may help lengthen the time your bladder can hold urine. […] Join a support group. Contact the ICNetwork at www.ic-network.com/ic-support-center/canada-ic-bladder-pelvic-pain-support-groups, or the Chronic Pain Association of Canada at https://chronicpaincanada.com/supportgroups.html for more information. […] Talk to a counsellor. Look for one who has had training in managing chronic pain.

• #26 Patient education: Treatment of interstitial cystitis/bladder pain syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-of-interstitial-cystitis-bladder-pain-syndrome-beyond-the-basics/print

  Online or local support groups that deal with chronic pain may also be helpful, such as the American Chronic Pain Society and the Academy of Integrative Pain Management. […] Relaxation techniques can relieve musculoskeletal tension and may include meditation, progressive muscle relaxation, self-hypnosis, or biofeedback. […] BEHAVIORAL THERAPY FOR BLADDER PAIN […] Behavioral therapies are treatments that can improve bothersome symptoms through changes in behavior. For people with IC/BPS, one of the more bothersome symptoms is the need to frequently urinate. Behavioral therapies for urinary frequency work to slowly increase the time interval between voids, which increases the amount of urine the bladder can comfortably hold; this is called timed voiding. […] A typical timed voiding protocol involves learning to urinate „by the clock” rather than voiding when there is an urge. This is used throughout the day but is not used while sleeping.

• #27 Patient education: Treatment of interstitial cystitis/bladder pain syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-of-interstitial-cystitis-bladder-pain-syndrome-beyond-the-basics/print

  As an example, if you currently void every 30 minutes, you will first try to urinate only once every 45 minutes during the daytime, whether you feel the need to urinate or not. You should not urinate more frequently than every 45 minutes, if possible. This voiding goal is continued for a full week or until you are comfortable with this interval. […] If you are comfortable voiding every 45 minutes, you can increase your time interval by 15 to 30 minutes every week. In this example, you would urinate every 60 minutes for the second week, every 90 minutes for the third week, every 2 hours for the fourth week, and every 2.5 hours for the fifth week. […] Timed voiding is inexpensive and has no side effects. In one small study of patients with IC, timed voiding significantly reduced symptoms of IC/BPS.

• #28 Patient education: Treatment of interstitial cystitis/bladder pain syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-of-interstitial-cystitis-bladder-pain-syndrome-beyond-the-basics/print

  PHYSICAL THERAPY FOR PAINFUL BLADDER […] Many men and women with IC/BPS have tight and tender muscles and connective tissue in the pelvis, lower abdomen, thighs, groin, and buttocks. Tight muscles and connective tissue can be diagnosed during a physical examination. […] Pelvic floor physical therapy (PT) may be recommended to decrease tightness in these muscles. PT can decrease bladder or pelvic pain as well as urinary urgency and frequency. This type of PT is quite different from physical therapy intended to treat a knee injury or back pain, which usually works to increase muscle strength. With pelvic floor PT, you lie flat as the physical therapist works on your body to manually „release” the tightness, tender points, trigger points, and restricted movement of the connective tissues and muscles. This includes the muscles and tissues of the vagina or rectum, abdomen, hips, thighs, and lower back. Physical therapists who perform this type of PT must be specially trained in pelvic soft tissue manipulation and rehabilitation.

• #29 Patient education: Treatment of interstitial cystitis/bladder pain syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-of-interstitial-cystitis-bladder-pain-syndrome-beyond-the-basics/print

  Several studies have demonstrated the benefit of PT for tight and tender pelvic muscles associated with IC/BPS. One study reported that 70 percent of IC patients who were treated with manual physical therapy to the pelvic floor tissues for 12 to 15 visits experienced moderate to marked improvement. Another study found that 59 percent of women had improvement in their IC/BPS symptoms after pelvic physical therapy, compared with only 29 percent of women who had improvement after treatment with standard full-body therapeutic massage. […] Pelvic floor PT is usually performed for one hour once per week for at least 12 weeks. You will also be given stretching exercises to perform at home. Most people begin to see improvement after six to eight sessions. If you are not able to tolerate PT due to pain, a local anesthetic can be injected into the painful muscles before PT to reduce pain and allow the therapist to work more effectively.

• #30 Patient education: Treatment of interstitial cystitis/bladder pain syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-of-interstitial-cystitis-bladder-pain-syndrome-beyond-the-basics/print

  ORAL MEDICATIONS FOR BLADDER PAIN […] Amitriptyline — Amitriptyline (Elavil) is an antidepressant that is commonly used to treat people with chronic pain. When used to treat pain, the dose of amitriptyline is typically much lower than that used for treating depression. It is believed that amitriptyline reduces pain perception when used in low doses, but the exact mechanism of its benefit is unknown. In the United States, amitriptyline is not approved for the treatment of pain caused by IC/BPS, although it is safe and effective for the treatment of other pain conditions. […] Common side effects of amitriptyline are fatigue, dry mouth, weight gain, and a decrease in blood pressure after sitting up or standing up. Amitriptyline is generally started at a low dose (10 to 25 mg) and increased gradually. This medicine can cause drowsiness and is usually taken at bedtime. The pain relief benefit may not be seen for three or more weeks.

• #31 Patient education: Treatment of interstitial cystitis/bladder pain syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-of-interstitial-cystitis-bladder-pain-syndrome-beyond-the-basics/print

  Pentosan polysulfate sodium — Pentosan polysulfate sodium (PPS; Elmiron) is an oral medication that was developed to repair the lining of the bladder in people with IC/BPS. Studies have shown that this medication is effective in reducing symptoms in some patients with IC/BPS, although it rarely causes the symptoms to go away completely. It can take three to six months of treatment before a benefit is observed. Side effects are usually mild and include hair loss, gastrointestinal symptoms, and increased liver function tests. Eye problems (retinal changes) have been reported in patients who have taken PPS, so it is important to have regular eye examinations if you are taking this medication. […] Other medications — Oral antihistamines such as hydroxyzine (Atarax, Vistaril) have been used to treat IC/BPS, with variable results. The typical dose is 25 to 50 mg at bedtime. This medication can cause drowsiness. Oral pain medications including nonsteroidal anti-inflammatory drugs (eg, ibuprofen, naproxen) and medications for urinary discomfort are also utilized.

• #32 Interstitial Cystitis Treatment & Management: Approach Considerations, Behavioral Therapy, Dietary Therapy

  https://emedicine.medscape.com/article/2055505-treatment

  Avoiding these food items or substituting other food items is often advised. […] Patients may be instructed to fill out a food diary, recording the relationship between the consumption of various food and drink items and their interstitial cystitis symptoms. […] Oral medications should be considered only after the aforementioned conservative measures have failed. […] The duration of individual pharmacotherapy is variable. […] In a randomized, double-blind, placebo-controlled study, amitriptyline was shown to provide statistically significant improvement in the O’Leary-Sant interstitial cystitis symptom index and problem index, pain, and urgency intensity. […] Most clinicians tend to avoid the extensive use of narcotics in patients with interstitial cystitis. […] When the pain component becomes unresponsive to nonnarcotic agents, referral to a chronic pain management facility may be helpful.

• #33 Interstitial Cystitis Treatment & Management: Approach Considerations, Behavioral Therapy, Dietary Therapy

  https://emedicine.medscape.com/article/2055505-treatment

  Managing the pain component can be difficult in patients with interstitial cystitis/bladder pain syndrome (IC/BPS). […] Some patients require long-term pain medications, while others rely on analgesics only during periods of symptomatic flares. […] Agents used for pain relief include the following: Anti-inflammatory drugs, Acetaminophen, Gabapentin, Tricyclic antidepressants, Selective serotonin reuptake inhibitors (SSRIs), Various other agents. […] Patients in whom medical therapy fails may benefit from another bladder hydrodistention if the initial diagnostic hydrodistention was therapeutic. […] If patients still do not respond, intravesical therapy may be initiated, beginning with weekly dimethyl sulfoxide (DMSO) therapy for 6 courses. […] In patients who respond poorly to DMSO, intravesical heparin or sodium oxychlorosene (Clorpactin) may be tried.

• #34 Patient education: Treatment of interstitial cystitis/bladder pain syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-of-interstitial-cystitis-bladder-pain-syndrome-beyond-the-basics/print

  Other bladder instillations — Some health care providers recommend a combination of medications, which are instilled into the bladder with a catheter, to reduce symptoms of pain. This can be done in a clinician’s office, or you can learn to self-administer the treatment at home. […] The treatment may be used as a single „rescue” treatment when symptoms are severe, or as a regularly scheduled treatment (eg, three times per week for a period of weeks). The medications are in a liquid form and are a small amount (approximately 15 mL or 0.5 ounces). You hold the liquid in the bladder for as long as possible and then urinate normally. […] The combination of medications may include lidocaine, heparin, and sodium bicarbonate. It is believed that this combination helps to repair the bladder lining and decrease nerve sensitivity in the bladder.

• #35 Patient education: Treatment of interstitial cystitis/bladder pain syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-of-interstitial-cystitis-bladder-pain-syndrome-beyond-the-basics/print

  In one small study, approximately 80 percent of patients had decreased pain for at least four hours after one treatment with heparin, sodium bicarbonate, and lidocaine. In addition, some patients experience reduced pain for days or weeks after bladder installations. […] BLADDER TREATMENT WITH BOTULINUM TOXIN […] Botulinum toxin can be injected into the bladder wall using a cystoscope. When injected into the bladder, botulinum toxin helps the bladder wall to relax, and it may also reduce abnormal bladder sensations. This treatment is sometimes used for urinary incontinence, but other studies have also shown it to be successful in certain patients with IC/BPS. The effect usually wears off after approximately six months, so repeated treatments are needed. The treatments should be provided by a clinician who is experienced with the management of IC/BPS, because side effects (such as bladder infections and difficulty urinating) can occur. Botulinum toxin is not approved by the US Food and Drug Administration for treatment of IC/BPS. Payment for it may not be covered by health insurance.

• #36 Patient education: Treatment of interstitial cystitis/bladder pain syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-of-interstitial-cystitis-bladder-pain-syndrome-beyond-the-basics/print

  ELECTRICAL STIMULATION FOR PAINFUL BLADDER […] If other treatments for IC/BPS fail to improve pain or cannot be tolerated, some clinicians will consider performing a surgical treatment called sacral nerve stimulation. This involves placing a small wire under the skin just above the tailbone. This wire sends a mild electrical pulse to nerves in the area; this pulse is thought to interrupt signals from the brain that trigger pain, urgency, and frequency in people with IC/BPS. Most patients can feel the electrical pulse, although it is not painful and usually becomes less noticeable over time. […] However, risks of the procedure include the need for a subsequent surgery to reposition or remove the wire or pulse generator, infection, bleeding, and pain. Anyone who is considering sacral nerve stimulation should discuss the risks and benefits with a clinician who is experienced and knowledgeable about all available treatments for IC/BPS.

• #37 Symptom Management and Nurses’ Role in Interstitial Cystitis/ Painful Bladder Syndrome

  https://fnjn.org/en/symptom-management-and-nurses-role-in-interstitial-cystitis-painful-bladder-syndrome-13781

  Interstitial cystitis or painful bladder syndrome is a chronic and progressive disease of the lower urinary tract, characterized by chronic pelvic pain, urinary frequency and urgency. […] The purpose of this review is to provide nurses with updated information on interstitial cystitis/painful bladder syndrome and to elucidate the nurses role and the methods used in the management of the symptoms which negatively affect patients lives.

• #38 Cystitis: Understanding the Symptoms, Prevention, and Nursing Interventions

  https://www.rn101.net/single-post/cystitis-understanding-the-symptoms-prevention-and-nursing-interventions

  Cystitis is a common urinary tract infection (UTI) that primarily affects women but can also occur in men. It refers to the inflammation of the bladder, often caused by bacteria entering the urethra and spreading to the bladder. […] Interstitial Cystitis: Also known as painful bladder syndrome, it is a chronic condition characterized by recurring pain and discomfort in the bladder. […] Nurses play a crucial role in managing and caring for individuals with cystitis. Some nursing interventions include: […] Administering Medications: Nurses may administer antibiotics or pain relievers as prescribed by the healthcare provider. […] Educating Patients: Providing information on proper hygiene, fluid intake, and medication adherence is essential for self-care management. […] Monitoring Symptoms: Nurses monitor the patient’s symptoms, such as pain, urinary frequency, and urine characteristics.

• #39 Cystitis: Understanding the Symptoms, Prevention, and Nursing Interventions

  https://www.rn101.net/single-post/cystitis-understanding-the-symptoms-prevention-and-nursing-interventions

  Promoting Comfort: Implementing comfort measures, such as applying heat packs or providing a comfortable environment, can alleviate discomfort. […] Assessing for Complications: Nurses assess for potential complications like kidney infection and ensure prompt medical intervention if needed. […] Cystitis is a common bladder infection that can cause significant discomfort and affect an individual’s daily life. Understanding the symptoms, prevention measures, and nursing interventions is essential for effective management and improved quality of life.

• #40 Interstitial cystitis: Simplified diagnosis and treatment

  https://www.contemporaryobgyn.net/view/interstitial-cystitis-simplified-diagnosis-and-treatment

  Most patients do not require ongoing intravesical therapy, although flares of symptoms can often be treated with a short course of 1 to 3 instillations. […] A few patients with severe symptoms will benefit from ongoing intravesical therapy. […] Such patients should schedule a nursing visit dedicated to learning how to prepare and perform home instillations. […] When caring for patients with IC, it is important to help them learn what works for them. […] Helping patients take charge of the management of their disease is the most effective strategy, and this will make patients grateful for the care you have provided.

• #41 Interstitial Cystitis/Bladder Pain Syndrome | IntechOpen

  https://www.intechopen.com/chapters/87191

  Interstitial cystitis/bladder pain syndrome (IC/BPS) is a heterogeneous, chronic, and debilitating condition. It affects 400,000 individuals in the United Kingdom. IC/BPS presents with suprapubic pain or discomfort perceived to be related to the urinary bladder with one or more urinary symptoms (e.g., urgency, frequency or nocturia) for more than 6 weeks. […] Management includes lifestyle modifications, physical therapy, systemic pharmacotherapy, intravesical therapies and surgery. Conservative treatments are usually used first, followed by invasive and combination therapies if required. Treatment should aim beyond symptom improvement and encompass improvement in quality of life. […] Management of IC/BPS is best delivered in a multidisciplinary approach and should focus on the quality of life in addition to symptoms.

• #42 Interstitial Cystitis/Bladder Pain Syndrome | IntechOpen

  https://www.intechopen.com/chapters/87191

  Patients education about the disease is vital to bring their expectations close to reality. Complex or resistant cases should be managed by multidisciplinary team approach. […] A small RCT (n = 33) compared DMSO to saline placebo. Patients treated with DMSO reported improvement in subjective symptom scores as well as in urodynamic parameters and voiding diary. […] Surgery is the last resort option in patients who fail all other therapies but still have significant symptoms. It is associated with considerable morbidity and mortality. Furthermore, every patient may not benefit from surgery. Therefore, patient selection is of utmost importance for achieving the desired outcomes.

• #43 The Evaluation and Management of Interstitial Cystitis/Bladder Pain Syndrome – European Medical Journal

  https://www.emjreviews.com/urology/article/the-evaluation-and-management-of-interstitial-cystitis-bladder-pain-syndrome/

  Pelvic floor physical therapy (PFPT) is a second-line treatment detailed in the AUA guidelines. Physical therapists must be specially trained to perform intravaginal myofascial release; the therapy also involves the manipulation of the patients external trunk and lower extremities. Treating the tenderness and tightness of the pelvic floor musculature can indirectly improve associated urinary, bowel, and sexual symptoms. […] The authors lead a clinic that involves urologists, gynaecologists, pelvic floor physical therapists, colorectal surgeons, integrative specialists, and pain psychologists who communicate together to tailor a multimodal therapy for each individual. A multidisciplinary clinic is extremely successful in managing IC/BPS patients, with very high patient satisfaction. […] A multidisciplinary approach is crucial for success in treating N-HLIC/BPS. It is critical to carefully phenotype these patients, identify pain triggers, and direct therapy towards these triggers. A hypertonic pelvic floor is often overlooked during the evaluation of a patient with symptoms suggestive of IC/BPS. In the authors opinion, identifying and treating PFD with physical therapy, trigger point injections, pudendal nerve blocks, integrative medicine treatments, psychological support, and neuromodulation offer the best success in the management of the refractory IC/BPS patient.

• #44

  https://link.springer.com/article/10.1007/s11884-025-00772-y

  Therapies offered to the IC/BPS patient may be broadly broken down into those that are strictly local to the bladder (hydrodistention of the bladder, bladder fulguration, botulinum toxin A trigonal injections, bladder instillations, urinary analgesics, pentosan polysulfate), those that affect the peripheral and/or central nervous system (tricyclic antidepressants, gabapentinoids, neuromodulation), and those that affect the pelvic floor musculature (physical therapy, skeletal muscle relaxants, trigger point injections). […] A robust dialogue between patient and clinician, setting realistic expectations and reviewing the various available management strategies is essential practice for all encounters. Simple strategies such as maintenance of adequate sleep, stress reduction, adequate fluid intake, and a bowel regimen, if needed, can often mitigate the need for more aggressive therapies. […] Psychological support should be considered in the appropriate patient.

• #45 Patient education: Treatment of interstitial cystitis/bladder pain syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-of-interstitial-cystitis-bladder-pain-syndrome-beyond-the-basics/print

  Depression is common in people with chronic pain and can interfere with the success of any treatment regimen. Therefore, evaluation and treatment of depression are recommended, if needed. […] There are several types of psychosocial support: […] Psychotherapy involves meeting with a psychologist, psychiatrist, or social worker to discuss emotional responses to living with chronic pain, treatment successes or failures, and/or personal relationships. […] Group psychotherapy allows people to compare their experiences with IC/BPS, overcome the tendencies to withdraw and to become isolated in pain, and support each other’s attempts at more effective management. […] National support groups are also available, including the Interstitial Cystitis Association and the Interstitial Cystitis Network.

• #46 Painful Bladder Syndrome (Interstitial Cystitis) | Doctor

  https://patient.info/doctor/interstitial-cystitispainful-bladder-syndrome-pro

  Analgesics should be used, preferably in collaboration with a pain clinic. […] Oral treatment with ciclosporin has been shown to be a beneficial therapeutic strategy for some patients with PBS. […] All ablative organ surgery should be the last resort for experienced and knowledgeable surgeons only. […] Major surgery (subtotal cystectomy and bladder augmentation or supravesical urinary diversion with intact bladder) is associated with good symptom relief in strictly selected patients with disabling IC/PBS, where conservative treatment has failed. […] The prognosis is very variable. The condition can have complete resolution of symptoms within months. […] IC/PBS can have a significant and even profound effect on self-esteem, sexual function and quality of life.

• #47 Painful Bladder Syndrome (Interstitial Cystitis) | Doctor

  https://patient.info/doctor/interstitial-cystitispainful-bladder-syndrome-pro

  Painful bladder syndrome (PBS) is a chronic condition of unknown cause. The common symptoms include urinary urgency, frequency, nocturia and suprapubic or pelvic pain without any known aetiological factor. The term 'interstitial cystitis’ is usually reserved for patients with typical cystoscopic features. […] PBS is the occurrence of persistent or recurrent pain perceived in the urinary bladder region, accompanied by at least one other symptom, such as pain worsening with bladder filling and daytime and/or night-time urinary frequency. There is no proven infection or other obvious local pathology. It is often associated with negative cognitive, behavioural, sexual or emotional consequences, as well as with symptoms suggestive of lower urinary tract and sexual dysfunction. […] Management is often difficult and only partially effective. Early diagnosis, support and management are very important.

• #48 Urology & Continence Care Today | May 2025

  https://www.ucc-today.com/journals/issue/launch-edition/article/interstitial-cystitis-facilitating-earlier-diagnosis-and-treatment-ucct

  There is no cure for interstitial cystitis and there is no one specific treatment which will be effective for everyone (NIDDK, 2017). […] Patients may also need to try more than one treatment, either singly or in combination, before finding something which suits them (NHS, 2022). […] Bladder instillations involve insertion of drugs directly into the bladder and may be offered for those who have failed to respond to any of the other available options. […] Even when symptoms settle flare ups may occur. […] IC is clearly a complex, highly challenging condition which currently has no cure. […] This article hopes to give nurses and non-medical prescribers a greater awareness of signs and symptoms, with the aim of increasing their confidence in recognising its unpleasant effects, so that they can get those affected earlier investigations and treatment, which will ultimately impact on their ability to cope with this condition and improve quality of life.

• #49 Patient education: Treatment of interstitial cystitis/bladder pain syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-of-interstitial-cystitis-bladder-pain-syndrome-beyond-the-basics/print

  Certain conditions, such as bladder infections or gastrointestinal problems […] Certain activities, such as sex and prolonged sitting […] Foods and beverages, including spicy foods, alcohol and coffee […] Aggravating conditions — Conditions such as bladder infections and vaginal infections can worsen IC/BPS symptoms and should be evaluated and treated promptly. Because symptoms of these other conditions are often similar to those of IC/BPS, most patients should see a healthcare provider to confirm their diagnosis, rather than simply self-treating based on symptoms. […] Other disorders that cause pain should also be treated, since pain in other areas may increase bladder sensitivity. These disorders include inflammatory bowel disease (Crohn’s disease, ulcerative colitis, diverticulitis), irritable bowel syndrome, painful menstrual periods, kidney stones, or endometriosis. More than one healthcare provider or specialist is often needed for people who have multiple medical conditions.

• #50 Interstitial Cystitis – Oregon Urology Institute

  https://oregonurology.com/interstitial-cystitis-ic/

  Maintaining a bladder voiding schedule Having scheduled times to void and gradually increasing the time between bathroom trips can improve urgency symptoms. […] […] During an IC flare-up, try these self-care measures to help minimize your discomfort: Stay well-hydrated by drinking extra water. […] […] IC is often a chronic condition. Many people with IC experience long-term symptoms that can fluctuate in severity over time. While you may have periods of remission where symptoms improve or disappear, others may have ongoing, persistent discomfort. Chronic IC requires ongoing management, and treatment plans are usually personalized and may need to be adjusted over time to remain effective.

• #51 Interstitial Cystitis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/15735-interstitial-cystitis-painful-bladder-syndrome

  The following may help reduce the length and severity of your interstitial cystitis/bladder pain syndrome flare-ups: […] Schedule an appointment with a healthcare provider if you have symptoms of interstitial cystitis/bladder pain syndrome. […] Go to the nearest emergency room if your symptoms are severe or dont go away after treatment. […] Interstitial cystitis/bladder pain syndrome is a common, chronic condition that causes inflammation and discomfort in your bladder area.

• #52 Interstitial Cystitis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/15735-interstitial-cystitis-painful-bladder-syndrome

  Exercise and physical activity may help relieve IC/BPS symptoms, including: […] Stress may trigger IC/BPS flare-ups. Learning to recognize and manage stress may help alleviate your symptoms. […] Your pelvic floor muscles hold your bladder in place and help control when you pee. Strengthening (Kegel exercises), stretching and especially relaxing your pelvic floor muscles can help relieve interstitial cystitis/bladder pain syndrome symptoms. […] Bladder retraining helps you overcome this habit by training you to hold your pee for longer periods. […] A provider may refer you to a dietitian to help you create the best eating patterns to reduce IC/BPS symptoms. […] A provider will insert a thin, plastic tube (catheter) in your urethra and guide it up to your bladder. […] A provider may recommend surgery if you have severe IC/BPS symptoms and dont respond to other treatments.

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