Symptoms of bladder pain syndrome (BPS) include:

• bladder pain or pain in your lower tummy or back
• feeling like you need to pee, even when your bladder is empty
• peeing often, usually just small amounts, during the day
• waking up at night to pee
• leaking out a small amount of pee if you do not get to a toilet quickly enough
• pain during sex - women can find sex (penetration) painful and men can find getting an erection painful

You may also feel discomfort when your bladder fills up after drinking. You may get some relief when you pee.

Symptoms of BPS can come and go over time. There are usually times where your symptoms get worse (called flare-ups) and times where they are better.

BPS is more common in women than men and usually affects people aged 40 or above.

See a GP if:

Ask for an urgent GP appointment or get help from NHS 111 if:

There is no single test that can diagnose bladder pain syndrome (BPS). You might need several tests to check for other conditions that could be causing your symptoms, such as a urinary tract infection (UTI).

You may need to have tests such as:

• a blood test
• a pee test (urine test)
• a physical examination of your pelvis, and genitals (which may include an internal vaginal exam)
• an ultrasound scan of your tummy
• a cystoscopy to look inside your bladder using a thin tube with a camera inside it
• measuring the pressure inside your bladder using a thin tube (catheter)

There is currently no cure for bladder pain syndrome (BPS). But there are treatments that can help manage your symptoms such as pain.

Your doctor will talk to you about the different options and what might work best for you.

If treatment is not working or your symptoms are severe, you may be referred to a specialist in treating bladder conditions (urologist).

Medicines

Medicines that can help the symptoms of BPS include:

• everyday painkillers like paracetamol and ibuprofen
• painkillers to treat nerve pain like amitriptyline, gabapentin or pregabalin
• medicines that make you pee less like oxybutynin

If other treatments have not worked, you may be offered a medicine called pentosan polysulfate sodium to protect your bladder from irritation, or medicine given through a thin tube (catheter) to numb your bladder or reduce your need to pee.

Surgery

Surgery is not common for BPS, but it may be recommended if other treatments have not helped.

Possible options include:

• injecting your bladder with Botulinum toxin (botox) to numb it
• inserting a small device under the skin in your lower back that sends signals to the nerves controlling your bladder (the medical term for this procedure is sacral nerve stimulation)
• expanding your bladder by using tissue from elsewhere in your body

Treatment and support for bladder pain syndrome (BPS)

There is other treatment and support that can help with the symptoms and problems caused by BPS.

This may include:

• physiotherapy to strengthen your pelvic floor muscles
• bladder retraining exercises
• help with managing long-term pain
• mental health support if you have low mood or anxiety
• advice on what you can do if symptoms are affecting your sex life (loss of libido)

There are things you can do to manage the symptoms of bladder pain syndrome (BPS).

The symptoms of bladder pain syndrome (BPS) are caused by the inner lining of the bladder (the bladder wall) becoming irritated and inflamed. But it is unclear why this happens in some people.

It's thought it may be caused by:

• your immune system mistakenly attacking your bladder wall, causing inflammation
• a problem with your bladder wall which makes it easily irritated by substances in your pee

You are more likely to get BPS if you already have another long-term pain condition like fibromyalgia.