Painful bladder disease

The painful bladder disease complex includes a large group of patients with pain in the area of the bladder, irritative voiding symptoms (urgency, frequency, nocturia, dysuria), and uninfected urine. Although there are diseases associated with painful bladder that have a well-known aetiology — such as radiation cystitis, cystitis secondary to chemotherapy, and carcinoma in situ, which is a premalignant condition of the bladder — the aetiology of the painful bladder in most patients is unknown. In this large group, mostly women, only a few specific diagnostic criteria have been established for the condition (including pinprick bleeding and Hunner's ulcers on the bladder wall) aand only limited therapy exists.

One of these conditions, interstitial cystitis, is a sterile inflammation of the bladder that includes symptoms of urinary frequency, urgency, pain on urination, and extreme pain in the area of the bladder and pelvis. Confusion in defining and understanding interstitial cystitis has resulted in the failure to diagnose and treat thousands of afflicted patients, committing them to a life of intractable pain. Even with diagnosis, there are no uniformly effective treatments.

Interstitial cystitis affects up to 450,000 people in the United States, 90% of whom are women. Undiagnosed or misdiagnosed