What is bladder pain syndrome?

Bladder pain syndrome (BPS): Overview

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.

Doctors do not know what causes BPS. But they do know that it is not caused by an infection. Your doctor may do tests to make sure that you do not have an infection, kidney stones, or bladder cancer.

People with BPS often also have another condition, such as irritable bowel syndrome, painful menstrual periods, or fibromyalgia.

It may take several weeks or months to find a treatment that works. If diet and lifestyle changes do not help, you may need medicine. Your doctor may also put liquid or medicine into your bladder for a short time to treat the pain.

What are the symptoms of bladder pain syndrome (BPS)?

Pain from BPS can get worse the longer you wait before urinating. It's common to have more pain as the bladder fills and some relief after you urinate. Other symptoms include urinating often, feeling a constant urge to urinate, having pain during or after sex, and having pain in your belly or pelvis.

How is bladder pain syndrome (BPS) treated?

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).

  • If you find you are urinating every 30 minutes, for example, you can set a schedule of going every 45 minutes during the day.
  • If that works for a week, you may be able to increase your time to every 60 minutes.
  • Slowly work your way up to 2½ hours.
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.

  • Medicines taken by mouth (oral medicines) include amitriptyline, pentosan polysulfate, antihistamines, and anti-inflammatory medicines.
  • Medicines that are put into the bladder (bladder instillations) are often combined with other medicines. These include medicines such as dimethyl sulfoxide (DMSO), lidocaine, heparin, and sodium bicarbonate.

A professional counselor can help you cope with pain, stress, and depression. It may also help to join a support group for people with BPS or chronic pain.

Other treatments.

These include botulinum toxin injections in the bladder and acupuncture. These have been helpful for some people.


If no other treatments help, surgery may be needed. It might be done to stop nerve pain or help with a problem like bladder distension. As a last resort, surgery may be done to remove the bladder.

Your doctor may have you use a bladder diary to record how often you urinate and about how much urine is released.

How is bladder pain syndrome (BPS) diagnosed?

To diagnose bladder pain syndrome (BPS), your doctor may do a test called cystoscopy that uses a thin, lighted tube to see the inside of your bladder. You may also get a urine test to rule out other problems, such as a urinary tract infection.

How can you care for yourself when you have bladder pain syndrome (BPS)?

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.
  • Avoid any food or drink that makes your bladder pain worse, such as high-acid foods.
  • See if using heat or cold helps relieve pain. Try 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.
  • 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.
  • Smoking can irritate the bladder. If you smoke and need help quitting, talk to your doctor.

What is bladder pain syndrome (BPS)?

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.

What causes bladder pain syndrome (BPS)?

Some doctors think BPS may be caused by abnormal changes in the lining of the bladder. But the cause isn't clear.

Bladder pain syndrome (BPS): When to call

Call your doctor now or seek immediate medical care if:

  • You have symptoms of a urinary infection. For example:
    • You have blood or pus in your urine.
    • You have pain in your back just below your rib cage. This is called flank pain.
    • You have a fever, chills, or body aches.
    • You have pain when you urinate.
    • You have groin or belly pain.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You do not get better as expected.

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The content above contains general health information provided by Healthwise, Incorporated, and reviewed by its medical experts. This content should not replace the advice of your healthcare provider. Not all treatments or services described are offered as services by us. For recommended treatments, please consult your healthcare provider.