Written By: Women and Infants on August 4, 2025
Originally published: August 2020
Ever feel like you just went to the bathroom, only to feel like you have to go again?
Or maybe you’ve had that nagging pelvic pain that feels like a UTI, but your test comes back clear? If that sounds familiar, you’re not alone – and it might be something called Painful Bladder Syndrome (PBS).
Also known as bladder pain syndrome or interstitial cystitis, PBS is a condition that causes discomfort, pressure, or pain in the bladder. You might feel like you need to urinate constantly or suddenly. The symptoms can be mild or intense, and for some, they come and go – while others deal with them daily.
The good news? Although PBS isn’t caused by an infection and can feel confusing, it’s not as rare or untreatable as once believed. We now know that it affects both women and men, and there are ways to manage it.
What Causes PBS?
We don’t know the exact cause, but research suggests the bladder’s protective lining might not be working properly. When that happens, the nerves in the bladder wall can become overly sensitive, making the normal act of filling the bladder feel painful.
There could also be inflammation or allergy-like reactions involved. Some people notice symptoms after a bladder infection or injury, but that’s not always the case. PBS is also more common in those with other chronic conditions like irritable bowel syndrome (IBS), fibromyalgia, or chronic fatigue syndrome. It's not clear why, but these conditions often occur together.
What are the Symptoms of PBS?
- Frequent urination is a big one. While most people go around seven times a day and maybe once at night, someone with PBS might go much more often – day and night.
- Urgency is another one - that sudden, gotta-go feeling – and sometimes the sensation doesn’t go away, even after you urinate.
- Pain is also a hallmark. It might show up when the bladder is full, or in areas like the urethra, lower belly, vagina, lower back, or even the sitting area (perineum). For some, it’s constant; for others, it flares up.
Symptoms can worsen with certain foods, stress, or even during your period. Some women experience pain during or after sex.
How Is PBS Diagnosed?
Diagnosis can be tricky since there’s no single test that confirms PBS. But it starts with a visit to your provider for a physical exam and urine tests to rule out infections or other causes.
Do I Need a Cystoscopy?
A cystoscopy allows a doctor to look inside your bladder with a tiny scope and camera. For some, especially those with ongoing symptoms, a more involved version – called cystoscopy with hydrodistention – may be done under anesthesia to check for signs of PBS.
However, not everyone needs this test, and it doesn’t always show definitive results. Your doctor can help decide if it’s right for you.
What Can I Do About It?
There’s no one-size-fits-all treatment, but most people find relief with a combination of approaches. Some options include:
- Diet changes: Drinking more water can help dilute the urine, and avoiding bladder irritants (like caffeine or acidic foods) may reduce symptoms.
- Bathroom habits: Try holding off a little instead of going at the first urge. Aim for bathroom trips every one to two hours.
- Heat or ice: Applying to the lower abdomen or sitting area can bring relief.
- Pelvic floor physical therapy: Working with a specialized physical therapist can make a huge difference. PT can help relax tight muscles, ease nerve pain, and restore balance in the pelvic area. Sessions are typically once or twice a week for 8–12 weeks and may include at-home exercises.
The Spaulding Outpatient Center for Pelvic Health at Care New England is designed to offer interdisciplinary treatments and services to address your specific pelvic health needs.
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