[Bladder Pain Syndrome Associated with Detrusor Underactivity and Bladder Outlet Obstruction : A Case Report]

We report a case of bladder pain syndrome (BPS) in which pain improved with clean intermittent catheterization (CIC). The patient wasa 26-year-old woman who had experienced urinary frequency since childhood. Two years prior to visiting our hospital, her symptoms worsened, leading her to seek medical attention for increased frequency and bladder pain. Cystoscopy revealed no Hunner's lesions, but a voiding diary indicated reduced bladder capacity. A trial of bladder hydrodistension was performed without symptomatic improvement. She was referred to our department for further evaluation and management. Pressure-flow study (PFS) showed reduced detrusor contractility with significant abdominal straining during voiding. Although there was no post-void residual, she experienced severe voiding pain, prompting initiation of CIC. While her symptoms improved, attempts to discontinue CIC resulted in pain recurrence, and she continued CIC for over two years. This case highlights the diagnostic value of PFS and the potential effectiveness of CIC in selected BPS patients.