Pelvic Pain Treatment - FAQ & Links

Interstitial cystitis (IC) is a chronic inflammation and irritation of the bladder including perineum. The bladder may be spastic while at the same time be irritated, allowing acid to penetrate the bladder lining. The pain may increase as the bladder is filled with urine, causing sudden urges to urinate.

We have learned all about the cause for Bladder Pain Syndromes / IC.  It typically involves therapy directed toward healing the lining of the bladder such as a low acid diet, special medications placed directly into the bladder (by my staff, your local doctor or we can teach you how to do this) and oral medications like Elmiron or Cyclosporin A. At least 85% of patients also have other pelvic pain generators and these must be treated as well. These other sources of pain include overly tight pelvic floor muscles, bowel problems (like IBS) and Vulvodynia (chronic burning at the vaginal opening). Proper treatment after a carefully evaluation places most patients' symptoms into remission.

Most patients have more than one cause or pain generator. Pelvic floor muscle pain and bladder pain (interstitial cystitis or painful bladder syndrome) are the most common. Irritable bowel and endometriosis are also seen. At The Urogynecology Center, we will always carefully evaluate your history and your examination to determine what is triggering your pain. Rest assured... it is not in your head.

Myofascial pain must be treated by first determining why your muscles are in spasm. Causes include an injury, stress or other painful organs nearby – like your bladder, your vulva or your bowels. Treatments include treating the trigger as well as treating the muscles. Muscle therapies include muscle relaxers, physical therapy, injections (called trigger point injections) or even BOTOX®.

Establishing the proper diagnosis is key. Typically, patients with vulvodynia have hypersensitive nerves and tight or spastic pelvic floor muscles. Therapy must be directed toward both. Treatment includes physical therapy, muscle relaxers and a special compounded cream that involves the topical application of drugs that relax muscles and turn down the hypersensitive nerves.