Bladder and Uterus to Blame in Pelvic Pain

Chronic pelvic pain patients may also have bladder pain syndrome and endometriosis

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) When a woman's bladder and uterus are both acting up, the two can go hand-in-hand to cause pain.

Almost two-thirds of women that had chronic pelvic pain (CPP) also had bladder pain syndrome (BPS), according to a recently published study. The pain can also be tied to other issues with the uterus.

Based on these findings, researchers suggested that doctors look into both conditions if a woman already has one. Knowing about the tie between CPP and BPS may help doctors address the issues at the same time, so patients can manage and treat the issues early on.

"Excessive pelvic pain? Talk to your doctor."

BPS causes the bladder discomfort and pressure in women with chronic pelvic pain. The pain can be more intense if BPS is combined with endometriosis, a condition in which the lining of a woman's uterus grows out into other areas of her abdomen.

Having both endometriosis and BPS together can be difficult to manage, according to researchers.

The study, led by Anushka Tirlapur, a clinical research fellow at the Women's Health Research Unit at the University of London in the UK, aimed to find how many women have BPS alone and how many have both BPS and endometriosis together.

Researchers reviewed nine previous studies that involved the two conditions and were published through March 2012.

They also looked at conference information from the International Continence Society, a charity that focuses on improving quality of life for individuals with bowel, urinary and pelvic floor disorders.

The studies included more than 1,000 women who had chronic pelvic pain and were not pregnant or had cancer.

Researchers looked at women's symptoms in detail through laparoscopy and cystoscopy.

In laparoscopy, doctors insert a thin tube with a camera on the end into the pelvis through a small cut made in the patient's belly. Cystoscopy involves looking at the inside of the bladder and urethra with similar devices.

Two independent reviewers analyzed the studies to ensure the researchers made quality assessments on relevant material.

The researchers found that an average 61 percent of the women in the included studies had BPS and 70 percent of women had endometriosis.

At the same time, 48 percent of women had BPS and endometriosis together. Looking at each individual study, the percentage of women with both conditions ranged between 16 and 78 percent.

"The highest prevalences were noted in patients recruited from specialist clinics and operating lists," researchers wrote in their report.

"From the nine studies, in four studies patients suffered from CPP and urinary symptoms and notably, some of the highest prevalences of BPS were seen in these patients...," they wrote.

Researchers suggested that clinicians be aware that women can have both conditions and look at the possible causes for CPP to manage the conditions early on.

The researchers noted that some of the conditions could have been misdiagnosed since BPS has a wide range of symptoms. In addition, pain level measurements were not consistent across the surveys patients took.

Researchers also did not compare results across different ethnicities, which may skew results, as previous studies showed that endometriosis is more common among Asian women.

The study was published February 15 in the International Journal of Surgery. No funding was available for the study and the authors do not declare any conflicts of interest.

Reviewed by: 
Review Date: 
February 26, 2013
Last Updated:
August 15, 2013