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  • Bladder pain syndrome

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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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  • N30.10 Interstitial cystitis (chronic) without hematuria
  • N30.11 Interstitial cystitis (chronic) with hematuria

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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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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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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 (IADLs)
  • Eating disorder, anorexia
  • Fatigue
  • Inappropriate self-medication
  • Anxiety, depression
  • Dietary limitations: reduced caffeine, alcohol, citrus intake

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Possible Contributing Causes

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  • Female sex
  • Stress, anxiety
  • Urinary tract (UT) abnormalities
  • Defect in the ...

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