Updated: May 17
Bladder Pain Syndrome (BPS/IC ) is recognized as a cluster of symptoms that include painful urination, suprapubic pain, urinary urgency and frequency, pelvic pain and in some cases, pain radiating to back and legs. It is a diagnosis of exclusion, meaning you have to rule out other things in order to come to conclusion of Interstitial Cystitis. Not everyone will have Hunner's lesion that will show up on the cystoscopy, in-fact according to data, only about 5-10% % of patients have presence of Hunner's lesions.
So how do we know if the symptoms of pelvic pain, urinary urgency and frequency and others are not coming from pelvic floor muscle tightness or irritation of a nerve from pelvic floor dysfunction and they are present because of IC? Your bladder has a very close proximity to the pelvic muscles, so one will affect the other. This is why we see a lot of symptoms overlap between IC and Pelvic dysfunction. Studies show that about 80% of people with BPS/IC have some kind of pelvic floor dysfunction. And so your best bet is to first treat the pelvic floor conservatively or to treat it along side with the other IC treatments (diet/medicine).
A good chunk of IC patients also suffer from something called Vulvodynia (covered in the next blog in detail) which is a burning and painful sensation of vulva. This is another reason to get an evaluation from a pelvic health specialist.
Many patients that I see in the clinic are able to eliminate or learn to avoid flare ups of their symptoms with the help of pelvic floor physical therapy.These can include pelvic pain, supra-pubic pain or pressure, urinary urgency or frequency, straining to urinate, incomplete urination, dribbling after peeing.
For IC patients, the question or rather the confusion whether it is their IC flare up or it is the pelvic floor muscles acting up or if they got a UTI can be very frustrating. So unless it is very obvious UTI symptoms, I ask the patients to start with working on their pelvic muscles and go from there.
If you are not sure where to start visit your local Pelvic floor physical therapist who specializes in IC/BPS and they can guide you further.
Dr. Soni is actively involved to improve awareness about the pelvic floor muscle involvement in IC/BPS. She has been a speaker in the Global Interstitial Cystitis Conference since past 2 years and have conducted teachings in US and abroad on the same topic. She is a believer in holistic and wholistic approach to Pelvic health in IC and works alongside urologists, urogynecologists, pelvic pain specialists, functional medicine doctors to improve the outcomes in her patients.