Bladder Sensitivity Syndrome
Early-stage bladder hypersensitivity in women before formal IC/BPS diagnosis — the greatest prevention opportunity.
Overview
Bladder Sensitivity Syndrome describes early-stage urothelial hypersensitivity presenting as persistent urgency, frequency, and pelvic discomfort without meeting full IC/BPS diagnostic criteria. Cultures are negative, cystoscopy is normal, but the woman's quality of life is significantly impaired. This represents the critical intervention window to prevent progression to chronic IC/BPS.
Key Symptoms
- Persistent urgency without incontinence
- Frequency >8 times/day with small volumes
- Suprapubic pressure or mild pelvic discomfort
- Symptoms recurring despite negative urine cultures
- Flares with certain foods, stress, or hormonal changes
Pathophysiology
Early GAG layer thinning allows subclinical urinary irritant penetration, sensitizing afferent C-fibers without yet causing the structural changes seen in established IC/BPS. Prompt intervention can restore urothelial integrity before irreversible neurogenic changes occur.
Treatment Approach
Dietary trigger elimination, bladder retraining, oral PPS (Elmiron®) for GAG layer restoration, and close monitoring to prevent progression. Early treatment offers the best long-term outcomes.