UroToday Int J. 2009 In Press. doi:10.3834/uij.1944-5784.2009.08.03
Bladder Pain: Clinical Assessment and Treatment
INTRODUCTION: Bladder pain may arise due to infection, inflammation, trauma, cancer, or unknown reasons. Bladder pain may be acute, long term and/or associated with other symptoms and syndromes. The treatment of bladder pain must consider both the pain and the function of the bladder.
METHODS: The definition, physiology, assessment, pharmacological treatment, and nonpharmacological treatment of bladder pain are reviewed and discussed. Three cases of complex bladder pain are presented.
RESULTS: Bladder pain is a symptom, not a disease. There is no single therapy that is helpful for all patients. Multimodal pain therapy that is tailored to the patient's present situation, genetics, ongoing treatment, and previous treatment(s) may reduce pain and improve quality of life.
CONCLUSION: Multidisciplinary evaluation and referral to a pain specialist should be considered for patients with complicated bladder pain with or without associated long-term pain problems. Patients with complex bladder pain may benefit from a consultation and second opinion from a pain specialist early in the course of the workup and not as a last measure when everything else has failed. Multidisciplinary pain teams with pain specialists should be part of the network available for clinicians who provide care for patients with complex pain problems.
KEYWORDS: Bladder pain; Assessment of pain; TENS; Pharmacology; Analgesia
CORRESPONDENCE: Dagmar Westerling, M.D. Ph.D., Acute Pain Unit, Department of Anesthesiology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston Salem NC, 27157, USA (dagmar.westerling@med.lu.se).
CITATION: UroToday Int J 2009 Aug;2(4). doi:10.3834/uij.1944-5784.2009.08.03
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