Bladder pain syndrome

The bladder is a small, stretchy bag in your lower belly that holds pee. It fills up as your body makes urine, and when it’s full, you feel the need to go to the toilet. When you pee, the bladder squeezes to push the pee out.

Bladder pain syndrome causes long-lasting pain around the pelvic area and problems with urination. It’s also known as interstitial cystitis or painful bladder syndrome.

The exact cause of bladder pain syndrome isn’t clear, and it doesn’t happen because of an infection. Some experts think it might be caused by damage to the bladder from past infections, an allergic reaction, or the body’s immune system accidentally attacking the bladder. Bladder pain syndrome is more common in women than in men. It’s usually diagnosed in people between 30 and 40 years old, but it can affect people of all ages, including children and young adults.

Bladder pain syndrome isn’t caused by an infection, but it can feel similar to a bladder infection. The pain can range from mild to bad. Some people experience a mild ache that comes and goes, while for others, the pain is constant and strong enough to affect their sleep, work, and daily activities. Some women may also feel pain during or after sex.

The most common symptoms of bladder pain syndrome include:

• A bad pain below the belly button.
• Pain in the lower back.
• A strong urge to pee.
• Needing to pee more often than usual.
• Waking up several times during the night to go to the bathroom.

You might also notice that the pain gets worse after eating certain foods or drinking certain beverages, during times of stress, or after doing activities like sitting for long periods. Women might find their symptoms change during their menstrual cycle.

If you're experiencing any of these symptoms, it’s important to talk to your doctor. The sooner you get a diagnosis, the sooner you can get the right treatment.

Pain and quality of life assessment
Your doctor will ask about the pain and discomfort you feel in your bladder, both when it’s full and when it’s empty. You may be asked to fill out questionnaires to help your doctor understand how bad the pain is and how it affects your daily life. You may also be asked about any pain or problems you have before, during, or after sex, and how the condition affects your mental health.

Talking about anxiety and depression can be tough, but it’s really important to be honest with your doctor about how you’re feeling. You won’t be judged, and your answers will help your doctor provide the right support for you.

Physical examination
Your doctor will ask you to describe your symptoms and will do a physical exam to check for any tenderness in your pelvis or tummy. Your doctor may recommend a pelvic exam, which involves checking your genitals (the vagina and cervix for women, and the penis and scrotum for men) for any additional tenderness.

Prostate check (men only)
A prostate check, or digital rectal exam, is a quick test to check if your prostate is swollen or painful. During this exam, your doctor will insert a gloved and lubricated finger into your rectum to feel your prostate.

This might feel embarrassing, but the exam only takes a few seconds. You might feel some pressure or have the urge to urinate for a moment. The exam might be a little uncomfortable, and if your prostate is swollen, it might hurt a bit, but it won’t cause lasting pain.

Urine test
Your doctor may ask for a urine sample if they think your symptoms could be caused by an infection. The sample will be sent to a lab for testing. The results will help your doctor 
figure out if there’s a reason for your symptoms.

Cystoscopy
Your doctor might suggest a cystoscopy, which is a procedure to look inside your bladder using a small camera called a cystoscope. This might make you feel a bit nervous, but the test is important so your doctor can look for any known reasons for your bladder pain. A cystoscopy can feel uncomfortable or painful, especially if you already have bladder pain. To make it easier, you might get a local anaesthetic to numb the area where the camera goes in, or a general anaesthetic so you’ll be asleep during the procedure. In some cases, you may be given a spinal anaesthetic, which numbs the lower half of your body.

This video shows how a cystoscopy is done in more detail. 

Since doctors don't know exactly what causes bladder pain syndrome, there isn’t one treatment that works for everyone. But there are different options you can try, and we encourage you to keep trying until you find what works best for you. This can be frustrating, but with the right approach, relief is possible.

This chapter contains general information about bladder pain syndrome. It is not a substitute for professional medical advice or treatment. Always consult your doctor or healthcare provider for guidance on your individual medical situation.

Last updated: April 2025