The most common symptoms of painful bladder syndrome include:

• Intense pelvic pain in your lower abdomen
• Strong and sudden urge to urinate
• Needing to urinate more frequently than usual
• Pain in your lower tummy, when your bladder is filling up that is relieved when you urinate
• Waking up frequently in the night to urinate
• Pain when having sex

Other symptoms can include, difficulty urinating, blood in your urine or urinary incontinence.

There isn’t an exact answer to what causes painful bladder syndrome, but causes can include:

• A problem with the pelvic floor muscles used to control urinating
• An inflammatory reaction caused by your immune system

Some people who have been diagnosed with painful bladder syndrome, may have a long-term urinary tract infection (UTI) that hasn’t been picked up by current urine tests.

Painful bladder syndrome can also be affected by chronic conditions such as fibromyalgia, myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS) and irritable bowel syndrome (IBS).

You may find that your symptoms come and go over time, and that sometimes there will be periods of time lasting from days to weeks to months where your symptoms improve, and flare-ups when they’re worse.

Although there is no single test to diagnose painful bladder syndrome, your Consultant may recommend one or more of the following tests:

• Cystoscopy – where the Consultant uses a small, thin, tube with a camera to look inside your bladder
• Urine tests
• An ultrasound, MRI, or CT Scan – sometimes this may include examining your kidneys too
• A urodynamic assessment – a range of tests to check the function of your bladder and urethra
• Vaginal swabs

Medicines

Medication includes:

• Over-the-counter painkillers – such as paracetamol or ibuprofen
• Medicines for nerve pain – such as amitriptyline, gabapentin, pregabalin

To reduce the urge to pee, your Consultant may recommend tolterodine, solifenacin or mirabegron

Bladder installations

Some medicine can be passed through a thin tube called a catheter, directly into the bladder such lignocaine – a local anaesthetic that helps to numb the bladder.

Supportive therapies and treatments

Some people may find the following treatments useful:

• Physiotherapy or Specialist Nurse– a specialist in pelvic floor function will be able to help you relax your muscles and this may ease pain and discomfort
• Acupuncture to aid with pain relief
• TENS (transcutaneous electrical nerve stimulation) – a small battery-operated device is used to help relieve pain by sending electrical impulses into your body

Surgery

If you have lesions (clear abnormal areas) in your bladder or other methods of treatment did not work your Consultant may recommend one of the following procedures:

Bladder distension

Fluid is used to stretch the bladder to aid diagnosis, this may temporarily relieve symptoms

Cauterisation

The use of lasers or an electrical current to seal ulcers

Botulinum toxin injections

Botox is injected into the wall of your bladder to relieve the symptoms of frequent peeing and pain on a temporary basis

Neuromodulation

An implant that uses electricity to stimulate your nerves to reduce pain and the sudden urge to pee is placed into your body

The following may help to improve your symptoms:

• Reducing stress with exercise, warm baths, and meditation
• Making sure you are hydrated throughout the day
• Keeping a food diary, you notice that something you’ve eaten or drank triggers your symptoms