# Bladder Pain Syndrome With Repeated Bladder Hydrodistention—A Case of Functional Somatic Syndrome Considered in Relation to Alexithymia

## TL;DR

A patient with bladder pain syndrome and alexithymia showed partial relief with repeated hydrodistentions but required psychosomatic interventions.

## Contribution

Highlights the potential link between bladder pain syndrome and alexithymia, suggesting early psychosomatic care may be necessary.

## Key findings

- Bladder pain improved temporarily with hydrodistention but flared up within months.
- The patient's condition was associated with alexithymia and unresponsive to standard drug treatments.
- Psychosomatic interventions were considered essential for managing the chronic pain.

## Abstract

We present a patient with bladder pain syndrome (BPS) who underwent repeated bladder hydrodistentions.

A female patient visited our department because of refractory bladder pain. She was diagnosed with BPS; she had only mucosal bleeding after distention. Her bladder pain improved after hydrodistention; however, the symptoms flared up within a few months. She also consulted with the palliative care department and was diagnosed with chronic pain associated with alexithymia. Various drugs were administered; however, none were effective or continued because of side effects. It was also challenging for her to embrace introspective counseling. Ultimately, along with her strong desire, the hydrodistention continued every few months. Her bladder capacity was approximately 200 mL.

BPS with uncontrolled bladder pain may be a functional somatic syndrome associated with alexithymia, and interventions such as psychosomatic medicine could be necessary from the early stage.