Symptoms of Bladder Pain Syndrome

In: Bladder Pain Syndrome · 2012 · pp. 177–188 · doi:10.1007/978-1-4419-6929-3_12 · W102246783
book-chapter OA: closed CC0
Full text JSON View on OpenAlex View at publisher
AI-generated summary by claude@2026-06+body, 2026-06-11

Bladder pain syndrome (BPS) is characterized by bladder pain, urgency, frequency, and nocturia, with pain often driving the other symptoms.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

AI-generated deep summary by claude@2026-06, 2026-06-11 · read from full text

This chapter studied the defining symptoms and symptom patterns of bladder pain syndrome (BPS) at a conceptual level, describing high-level evidence from clinical characterization and the challenges of distinguishing BPS from other pelvic pain and urinary syndromes. It reports that bladder pain is the sole necessary criterion, with most patients reporting multiple pain sites (e.g., suprapubic, urethral, genital, and non-genitourinary), and that pain is considered a driving force for urgency and nocturia, while the cause of marked frequency is discussed as possible but not proven abnormal urge to void. The chapter explicitly notes difficulty constructing an instrument with adequate sensitivity/specificity to distinguish BPS from conditions including vulvodynia and endometriosis, and that etiologic relationships between BPS and related pelvic/systemic symptom syndromes remain unclear. Relevance to endometriosis: endometriosis is explicitly named among the pelvic syndromes that are difficult to distinguish from BPS when developing diagnostic instruments, though the chapter’s main focus is symptom characterization and diagnostic discrimination issues for BPS.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Full text 12,081 characters · extracted from oa-doi-fallback · 3 sections · click to expand

Abstract

The cardinal symptoms of bladder pain syndrome (BPS) are pain perceived to be from the bladder, urinary urgency and frequency, and nocturia. Bladder pain has become the sole necessary criterion of BPS. Most patients report multiple BPS pain sites: 83 % suprapubic, 36 % urethral, 23 % genital, and 29 % non-genitourinary sites. Pain appears to be the driving force of urgency and nocturia. When asked the cause of urgency, about three quarters of BPS patients report pain. In nocturia, pain may play a twofold role: directly in awakening the patient and indirectly in generating the sensation of urgency. The reason for the often marked frequency of BPS is considered but not proven to be a result of the abnormal urge to void. Present information indicates difficulty in constructing an instrument with adequate sensitivity and specificity to distinguish BPS from vulvodynia and endometriosis in women, BPH and CP/CPPS in men, and OAB and IBS in both sexes. Whether more detailed descriptions would be more discriminatory is unclear. Also unclear is the etiologic relationship of BPS to these pelvic syndromes and to systemic symptom-based syndromes such as fibromyalgia, chronic fatigue syndrome, and migraine. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

Hanno P, Lin A, Nordling J, Nyberg L, van Ophoven A, Ueda T, et al. Bladder pain syndrome committee of the international consultation on incontinence. Neurourol Urodyn. 2010;29(1):191–8. Koziol JA. Epidemiology of interstitial cystitis. Urological Clinics of North America. 1994;21(1):7–20. Simon LJ, Landis JR, Erickson DR, Nyberg LM, The ICDB Study Group. The interstitial cystitis data base study: concepts and preliminary baseline descriptive statistics. Urology. 1997;49(Suppl 5A):64–75. Warren JW, Langenberg P, Greenberg P, Diggs C, Jacobs S, Wesselmann U. Sites of pain from interstitial cystitis/painful bladder syndrome. J Urol. 2008;180(4):1373–7. Melzack R. The McGill pain questionnaire: major properties and scoring methods. Pain. 1975;1(3):277–99. Shorter B, Lesser M, Moldwin RM, Kushner L. Effect of comestibles on symptoms of interstitial cystitis. J Urol. 2007;178(1):145–52. Abrams P, Andersson KE, Birder L, Brubaker L, Cardozo L, Chapple C, et al. Fourth international consultation on incontinence recommendations of the international scientific committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn. 2010;29(1):213–40. van de Merwe JP, Nordling J, Bouchelouche P, Bouchelouche K, Cervigni M, Daha LK, et al. Diagnostic criteria, classification, and nomenclature for painful bladder syndrome/interstitial cystitis: an ESSIC proposal. Eur Urol. 2008;53(1):60–7. Hanno et al. Diagnosis and treatment of interstitial cystitis/bladder pain syndrome: AUA guideline. Annual meeting of the American Urological Association; May 2010 San Francisci, CA Warren JW, Diggs C, Horne L, Greenberg P. Interstitial cystitis/painful bladder syndrome: what do patients mean by “perceived” bladder pain? Urology. 2011;77(2):309–12. Peters K, Girdler B, Carrico D, Ibrahim I, Diokno A. Painful bladder syndrome/interstitial cystitis and vulvodynia: a clinical correlation. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(5):665–9. Coggon D, Martyn C, Palmer KT, Evanoff B. Assessing case definitions in the absence of a diagnostic gold standard. Int J Epidemiol. 2005;34(4):949–52. Reading I, Walker-Bone K, Palmer KT, Cooper C, Coggon D. Anatomic distribution of sensory symptoms in the hand and their relation to neck pain, psychosocial variables, and occupational activities. Am J Epidemiol. 2003;157(6):524–30. Kendell R, Jablensky A. Distinguishing between the validity and utility of psychiatric diagnoses. Am J Psychiatry. 2003;160(1):4–12. Gormley EA. Irritative voiding symptoms: identifying the cause. Hosp Pract (Minneap). 1999;34(13):91–6. quiz 108. Smith EM, Ritchie JM, Galask R, Pugh EE, Jia J, Ricks-McGillan J. Case-control study of vulvar vestibulitis risk associated with genital infections. Infect Dis Obstet Gynecol. 2002;10(4):193–202. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology of lower urinary tract function: report from the standardisation sub-committee of the international continence society. Neurourol Urodyn. 2002;21(2):167–78. Abrams P, Hanno P, Wein A. Overactive bladder and painful bladder syndrome: there need not be confusion. Neurourol Urodyn. 2005;24(2):149–50. Greenberg P, Brown J, Yates T, Brown V, Langenberg P, Warren JW. Voiding urges perceived by patients with interstitial cystitis/painful bladder syndrome. Neurourol Urodyn. 2008;27(4):287–90. Clemens JQ, Bogart LM, Liu K, Pham C, Suttorp M, Berry SH. Perceptions of “urgency” in women with interstitial cystitis/bladder pain syndrome or overactive bladder. Neurourol Urodyn. 2010;30(3):402–5. FitzGerald MP, Butler N, Shott S, Brubaker L. Bother arising from urinary frequency in women. Neurourol Urodyn. 2002;21(1):36–40. discussion 41. Glenning PP. Urinary voiding patterns of apparently normal women. Aust N Z J Obstet Gynaecol. 1985;25(1):62–5. Fitzgerald MP, Brubaker L. Variability of 24-hour voiding diary variables among asymptomatic women. J Urol. 2003;169(1):207–9. Burgio KL, Engel BT, Locher JL. Normative patterns of diurnal urination across 6 age decades. J Urol. 1991;145(4):728–31. van Kerrebroeck P, Abrams P, Chaikin D, Donovan J, Fonda D, Jackson S, et al. The standardisation of terminology in nocturia: report from the standardisation sub-committee of the international continence society. Neurourol Urodyn. 2002;21(2):179–83. Tikkinen KA, Johnson 2nd TM, Tammela TL, Sintonen H, Haukka J, Huhtala H, et al. Nocturia frequency, bother, and quality of life: how often is too often? A population-based study in finland. Eur Urol. 2010;57(3):488–96. Warren JW, Horne L, Diggs C, Greenberg P. Nocturia in interstitial cystitis/painful bladder syndrome. Urology. 2011;77(6):1308–12. Weiss JP, Weinberg AC, Blaivas JG. New aspects of the classification of nocturia. Curr Urol Rep. 2008;9(5):362–7. Held PJ, Hanno PM, Wein AJ, Pauly MV, Cahn MA. Epidemiology of interstitial cystitis: 2. In: Hanno PM, Staskin DR, Krane RF, Wein AJ, editors. Interstitial Cystitis. London: Springer; 1990. p. 29–48. Keller ML, McCarthy DO, Neider RS. Measurement of symptoms of interstitial cystitis. A pilot study. Urol Clin North Am. 1994;21(1):67–71. Goin JE, Olaleye D, Peters KM, Steinert B, Habicht K, Wynant G. Psychometric analysis of the University of Wisconsin interstitial cystitis scale: implications for use in randomized clinical trials. J Urol. 1998;159(3):1085–90. Porru D, Tinelli C, Gerardini M, Giliberto GL, Stancati S, Rovereto B. Evaluation of urinary and general symptoms and correlation with other clinical parameters in interstitial cystitis patients. Neurourol Urodyn. 2005;24(1):69–73. O’Leary MP, Sant GR, Fowler Jr FJ, Whitmore KE, Spolarich-Kroll J. The interstitial cystitis symptom index and problem index. Urology. 1997;49(5A Suppl):58–63. Lubeck DP, Whitmore K, Sant GR, Alvarez-Horine S, Lai C. Psychometric validation of the O’leary-sant interstitial cystitis symptom index in a clinical trial of pentosan polysulfate sodium. Urology. 2001;57(6 Suppl 1):62–6. O’Leary MP, Sant G. The interstitial cystitis symptom and problem indices: rationale, development, and application. In: Sant G, editor. Interstitial Cystitis. Philadelphia: Lippincott-Raven; 1997. p. 271–6. Parsons CL, Dell J, Stanford EJ, Bullen M, Kahn BS, Waxell T, et al. Increased prevalence of interstitial cystitis: previously unrecognized urologic and gynecologic cases identified using a new symptom questionnaire and intravesical potassium sensitivity. Urology. 2002;60(4):573–8. Moldwin R, K L. The diagnostic value of interstitial cystitis questionnaires. Meeting of the American Urological Association; 2004 May 9; San Francisco, CA. p. 96 Kushner L, Moldwin RM. Efficiency of questionnaires used to screen for interstitial cystitis. J Urol. 2006;176(2):587–92. Sirinian E, Payne CK. Correlation of symptoms between 2 instruments among interstitial cystitis patients. Urology. 2001;57(6 Suppl 1):124–5. Propert KJ, Mayer RD, Wang Y, Sant GR, Hanno PM, Peters KM, et al. Responsiveness of symptom scales for interstitial cystitis. Urology. 2006;67(1):55–9. Clemens JQ, Calhoun EA, Litwin MS, McNaughton-Collins M, Kusek JW, Crowley EM, et al. Validation of a modified national institutes of health chronic prostatitis symptom index to assess genitourinary pain in both men and women. Urology. 2009;74(5):983–7. quiz 987.e1–3. Berry SH, Bogart LM, Pham C, Liu K, Nyberg L, Stoto M, et al. Development, validation and testing of an epidemiological case definition of interstitial cystitis/painful bladder syndrome. J Urol. 2010;183(5):1848–52. Alagiri M, Chottiner S, Ratner V, Slade D, Hanno PM. Interstitial cystitis: unexplained associations with other chronic disease and pain syndromes. Urology. 1997;49(5A Suppl):52–7. Nickel JC, Tripp DA, Pontari M, Moldwin R, Mayer R, Carr LK, et al. Interstitial cystitis/painful bladder syndrome and associated medical conditions with an emphasis on irritable bowel syndrome, fibromyalgia and chronic fatigue syndrome. J Urol. 2010;184(4):1358–63. Warren JW, Howard FM, Cross RK, Good JL, Weissman MM, Wesselmann U, Langengerg P, Greenberg P, Clauw DJ. Antecedent nonbladder syndromes in case-control study of interstitial cystitis/painful bladder syndrome. Urology. 2009;73:52–7. Barry MJ, Fowler Jr FJ, O’Leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK, et al. The American Urological Association symptom index for benign prostatic hyperplasia. The measurement committee of the American Urological Association. J Urol. 1992;148(5):1549–57. discussion 1564. FitzGerald MP, Kenton KS, Brubaker L. Localization of the urge to void in patients with painful bladder syndrome. Neurourol Urodyn. 2005;24(7):633–7. Clemens JQ, Markossian TW, Meenan RT, O’Keeffe Rosetti MC, Calhoun EA. Overlap of voiding symptoms, storage symptoms and pain in men and women. J Urol. 2007;178(4 Pt 1):1354–8. discussion 1358. McMahon SB, Dmitrieva N, Koltzenburg M. Visceral pain. Br J Anaesth. 1995;75(2):132–44. Warren JW, Brown J, Tracy JK, Langenberg P, Wesselmann U, Greenberg P. Evidence-based criteria for pain of interstitial cystitis/painful bladder syndrome in women. Urology. 2008;71(3):444–8. Malykhina AP. Neural mechanisms of pelvic organ cross-sensitization. Neuroscience. 2007;149(3):660–72. Pezzone MA, Liang R, Fraser MO. A model of neural cross-talk and irritation in the pelvis: implications for the overlap of chronic pelvic pain disorders. Gastroenterology. 2005;128(7):1953–64. Tomaszewski JE, Landis JR, Russack V, Williams TM, Wang LP, Hardy C, et al. Biopsy features are associated with primary symptoms in interstitial cystitis: results from the interstitial cystitis database study. Urology. 2001;57(6 Suppl 1):67–81. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2013 Springer Science+Business Media New York About this chapter Cite this chapter Warren, J.W., Hanno, P.M. (2013). Symptoms of Bladder Pain Syndrome. In: Nordling, J., Wyndaele, J., van de Merwe, J., Bouchelouche, P., Cervigni, M., Fall, M. (eds) Bladder Pain Syndrome. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-6929-3_12 Download citation DOI: https://doi.org/10.1007/978-1-4419-6929-3_12 Published: Publisher Name: Springer, Boston, MA Print ISBN: 978-1-4419-6928-6 Online ISBN: 978-1-4419-6929-3 eBook Packages: MedicineMedicine (R0)

Keywords

- Irritable Bowel Syndrome - Chronic Fatigue Syndrome - Urinary Frequency - International Continence Society - Bladder Filling These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Citation neighborhood (no data yet)

We don't have any in-corpus citations linked to this paper yet. The paper's references may be in our DB but unresolved to ``paper_id`` (resolution happens at ingest when the cited DOI matches a row we already have). Run the cross-source citation reconcile pass to retry.

References (59)

Source provenance

openalex
last seen: 2026-06-04T00:00:01.174412+00:00
unpaywall
last seen: 2026-06-13T06:42:57.164913+00:00
License: CC0 · commercial use OK