Interstitial Cystitis (IC) and Bladder Pain Syndrome (BPS)

Many use the definitions of interstitial cystitis (IC) and bladder pain syndrome (BPS) interchangeably under the umbrella of chronic urologic pain, but many would agree there are differences in the presentations of the two.

What is agreed upon is that the symptoms of IC and BPS vary for each patient, but most often they resemble those of a urinary tract infection (UTI), although all tests are normal. Symptoms need to be present for greater than 3 months in the absence of infection or neoplastic disease.

Symptoms For IC/BPS Include:

• Pain that becomes worse with bladder filling.
• Urge to urinate is related primarily to pain, pressure or discomfort.
• Frequency of urination is greater than 8 times per day.
• Nocturia.
• Pain in pelvic, suprapubic, bladder, urethra, perineum, vagina, or groin.
• Dyspareunia.

Symptom severity is different for everyone, but patients often report a significant level of bothersome and negative impacts on many daily activities that affect their quality of life.

Canadian Urologic Association guidelines on the treatment of IC/BPS conservative therapies include:

• Patient education.
• Diet modification.
• Bladder training.
• Stress management and psychological support.
• Physical therapies.

Dr. Robert Moldwin, a leading American urologist in IC/BPS has stated that in 70-80% of patients, it is actually a pelvic floor dysfunction. Specifically, an overactive pelvic floor, so patients should not be doing Kegels. Also many patients have a sensitized nervous system that needs to be addressed.

Pelvic health physiotherapy has been shown to be an integral part of the multidisciplinary treatment of symptoms associated with IC/BPS. A biopsychosocial approach will better inform us on how to develop a personalized treatment plan.

Physiotherapy Treatments May Include:

• Diet modification.
• Bowel and bladder education.
• Bladder retraining techniques.
• Pain education.
• Stress management and progressive muscle relaxation.
• Therapeutic exercise such as stretching and yoga.
• External myofascial techniques including connective tissue massage.
• Internal myofascial techniques.
• Treatment of the nervous system.

Click here on how to find a pelvic health physiotherapist in your area.