Bladder pain syndrome 36

Shahed Borojeni, Benoit Peyronnet.
Abstract
Bladder pain syndrome (BPS), often associated with other pelvic pain syndromes, is defined as perceived chronic pain or discomfort related to the bladder, associated with other urinary symptoms such as pollakiuria or a constant urge to urinate, in the absence of organic pathology. It more often affects women. Assessment is clinical, including a voiding schedule and standardized questionnaires measuring impact on quality of life. The key examination is cystoscopy, under local or general anaesthetic, to rule out the differential diagnosis of bladder tumour and separate VDS into two entities or phenotypes: hypersensitive bladder, with no lesion of the bladder wall, and "interstitial cystitis" with parietal lesion, characterized by the presence of specific histological and sometimes endoscopic lesions such as Hunner's ulcerations. Pathophysiology is thought to differ between these entities, involving multiple factors such as inflammation, autoimmunity, infection, environment, urothelial barrier dysfunction, pelvic or central sensitization and extra-vesical disorders. BPS requires comprehensive, multidisciplinary patient management. The first line of treatment usually includes cystoscopy with hydrodistension in the case of parietal forms, introduction of amitriptyline, physiotherapy, diet and TENS (Transcutaneous Electrical Nerve Stimulation). A better understanding of the underlying mechanisms would enable us to propose an even more individualized treatment, specific to the BPS phenotype.
Keywords : Pelvic Pain.
June 2025
La revue du praticien n° Tome 75 / n° 17 PDF