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Condition/Disorder Synonym

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  • Bladder pain syndrome

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ICD-9-CM Codes

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  • 595.1 Chronic interstitial cystitis

  • Associated Physical Therapy Diagnoses

    • 315.4 Coordination disorder (clumsiness, dyspraxia and/or specific motor development disorder)

    • 718.45 Contracture of joint, pelvic region, and thigh

    • 719.70 Difficulty in walking

    • 728.2 Muscular wasting and disuse atrophy

    • 728.89 Disorders of muscle, ligament, and fascia

    • 729.9 Other disorders of soft tissue

    • 780.7 Malaise and fatigue

    • 782.3 Edema

    • 786.0 Dyspnea and respiratory abnormalities

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ICD-10-CM Codes

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  • N30.10 Interstitial cystitis (chronic) without hematuria

  • N30.11 Interstitial cystitis (chronic) with hematuria

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Preferred Practice Pattern

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  • As of August 2012, the APTA Guide to Physical Therapist Practice does not include practice patterns for organ system pathology. Therefore, the associated or secondary musculoskeletal, cardiovascular/pulmonary, or potential neuromuscular patterns would be indicated.

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Key Features

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Description

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  • Chronic inflammation of the bladder wall

  • Frequent, painful urination

  • Severe pain with or without attempts at urination, or no pain at all, especially in elderly and children

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Essentials of Diagnosis

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  • Unknown etiology

  • Frequent, painful urination

  • Difficulty urinating

  • Pelvic pressure

  • Lower-abdomen discomfort

  • Pelvic pain in women

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General Considerations

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  • Often misdiagnosed as urinary tract infection (UTI)

  • Some urogynecologic (UG) pathologies may be appropriate for PT, though PT does not usually treat UG disorders specifically.

  • Diagnosis for occult problems may take time, require intensive diagnostic testing.

  • May refer pain to back, pelvic region.

  • UG disorders frequently refer pain to other body areas; individuals may be inappropriately referred to PT.

  • May mimic colon cancer or tumor, irritable bowel, colitis.

  • May mimic gynecologic problems in females: endometriosis, uterine fibroids, ectopic pregnancy.

  • Can have periods of remission

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Demographics

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  • Women more susceptible than men: female-male ratio 10:1

  • Diagnosed in the 40 year old age group.

  • Frequently associated with sexual intercourse

  • Children also at risk

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Clinical Findings

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Signs and Symptoms

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  • Bladder pressure and pain

  • Pain during sexual intercourse

  • Reduced bladder capacity

  • Urinary discomfort, frequency, or urgency

  • Pelvic pain

  • Urethra (urethritis)

    • Burning with urination

  • Bladder (cystitis)

    • Pelvic pressure

    • Lower-abdomen discomfort

    • Frequent, painful urination

    • Blood in urine

  • Kidney (acute pyelonephritis)

    • Upper-back and side (flank) pain

    • High fever

    • Shaking, chills

    • Nausea

    • Vomiting

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Functional Implications

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  • Patients often self-confine to house due to fear of not being near a bathroom.

  • Severe symptoms, such as urgent need to urinate, may be disabling, cause inability to leave home.

  • Pain

  • Urinary retention

  • Dehydration secondary to diarrhea, emesis, appetite loss, nausea, inability to swallow

  • Sarcopenia resulting in weakness, decreased muscle mass, inability to ambulate, perform self-care

  • Presence of catheters (external, indwelling, intermittent) may present problems with stoma retraction associated with abdominal contraction.

  • Decreased exercise tolerance

  • Limited physical activity, activities of daily living (ADLs), instrumental activities of daily living ...

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