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What's irritating your bladder?

Have you been experiencing pain in or around your bladder, having urgency or frequency with urination, or do you have the sensation of pressure and discomfort in your bladder? Many of these symptoms in the absence of any identifiable cause can be linked to a diagnosis of Interstitial Cystitis, or IC. The condition has also been called painful bladder syndrome, hypersensitive bladder, or bladder pain syndrome.

Many conditions can mimic the symptoms of IC. This is why it is important to see your provider to rule out possible urinary tract infections, bladder cancers, and bladder dysfunction or pelvic floor dysfunction. Diagnosis of IC is divided into two categories, those with ulcers on the bladder and those with no evidence of bladder pathology, such as an ulcer. Bladder ulcers are called Hunner’s lesions (ulcerations) or glomerulations (hemorrhages).

Symptoms of IC can include:

  • Lower abdominal pain or pelvic pain

  • Pressure or pain with bladder filling

  • Frequent urination

  • Small amounts of urine with urination

Tests Your Provider May Perform:

  • Urine sample-your provider will test your urine for signs of infection

  • Cystoscopy with and without distension (stretching)-a camera is used to look inside the bladder. With distension, the bladder is filled to capacity to identify small lesions or injuries which can not be viewed when the bladder is in a more relaxed position.

  • Biopsy of bladder and urethra-tissue from the bladder is taken and studied

Treatment Plan

Bladder pain syndromes and IC without ulcers

Interstitial Cystitis with ulcers

First line treatment

Elimination diet and stress management

Bladder directed therapies such as cauterization

Second line treatment

Pelvic floor physical therapy, oral medications, bladder instillations

Pelvic floor physical therapy

Third line treatment

Nerve blocks and trigger point injections

Nerve blocks and trigger point injections

Fourth line treatment



Fifth line treatment

Nerve stimulation

Suppress the immune system to suppress inflammation

Next line treatment

Nerve stimulation

Last treatment option

Reconstructive surgery

Complimentary therapies

Acupuncture, massage, guided imagery, and psychological therapies

Pelvic Floor Physical Therapy

Pelvic floor physical therapy is a secondary focus with interstitial cystitis without ulcers. These individuals often demonstrate multiple trigger points in muscles, tight tender muscles and connective tissue in their abdomen, groin, thighs, and buttocks. Pelvic floor dysfunction is very common with this diagnosis.

At The Fit Pelvis, we offer individualized and specialized treatment for pelvic floor dysfunction, bladder and bowel dysfunction, and pelvic pain. If you are interested in learning more, please visit for more information.

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