Physiotherapy for painful bladder syndrome - A narrative review

 Zohar Gov1, Rachel Kafri2, Shmuel Springer3

1Graduate of the Academic College at Wingate (B.Ed),
 A physiotherapy student, Department of Physical Therapy, School of Health Sciences, Ariel University, Israel
2Dr Kafri, Physiotherapist for pelvic and the pelvic floor rehabilitation
3Dr Shpringer, head of Physical Therapy Department, School of Health Sciences, Ariel University, Israel


Background: Painful bladder syndrome (PBS) is a condition that is characterized by recurring discomfort and pain in the bladder and the surrounding pelvic region, which affects women more commonly than men. The etiology of PBS is not clear, and it is likely multifactorial; however, research has found an association between pelvic floor muscle dysfunction and PBS.


Objective: The objective of this report is to present the current body of evidence regarding the etiology of the syndrome and to describe the physiotherapy treatment of patients with PBS.


Methods: A narrative review, based on online search of "PubMed" for scientific papers published between 2004 to 2016.


Results: Though the cause of PBS is unknown, many theories have been suggested in an attempt to explain it. The main theories are as follows: (1) Heredity, (2) Functional somatic syndrome initiated by childhood trauma, (3) Defect in bladder epithelium and continuous neurogenic inflammation, (4) Mast cell activation, (5) Stimulus from a body organ that affects the bladder, (6) Dysfunction of the pelvic floor muscles. Physiotherapy can improve patient care, by considering PBS early in the differential diagnosis, using bladder training techniques along with stress reduction methods. In addition, evidence indicates that certain types of manual techniques, when administered by an experienced hysiotherapist, ay alleviate PBS ymptoms.


Discussion and conclusions: As with other pain syndromes, physiotherapy may play a significant role in helping to ease PBS symptoms and pain. Thus, it is important for physiotherapists to gain knowledge about this syndrome and its treatment options. 


Key words: Painful bladder syndrome, Pain, physiotherapy, pelvic floor

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