What to do for urinary bladder pain with no urge for 2 years?

Given your symptoms of bladder pain and a lack of urinary urge over two years, despite comprehensive diagnostic exams like CT scans, MRIs, and ultrasounds, several considerations come to mind. It seems important to look into less common causes of these symptoms. One potential condition to consider is Interstitial Cystitis (IC), also known as painful bladder syndrome. It’s a chronic bladder health issue characterized by bladder pressure, bladder pain, and sometimes pelvic pain. It’s less about the urge to urinate, and more about the discomfort and pain. Management of IC often includes lifestyle changes—diet modifications to avoid bladder irritants such as caffeine, alcohol, and spicy foods can be helpful. Bladder training and pelvic floor physical therapy are also options. Medications like pentosan polysulfate sodium, amitriptyline, or antihistamines are sometimes prescribed to help reduce symptoms. It’s advisable to visit a urologist with experience in IC if you haven’t already. They can review your test results in detail and, if needed, perform additional tests like a cystoscopy or urodynamic test. Another possibility might be neurogenic bladder, due to nerve dysfunction possibly affecting bladder control. Consulting with a neurologist could provide more insights, especially if conditions like diabetes or spinal disorders are present. Meanwhile, if pain becomes unbearable, a visit to the emergency room may be in order. Prioritize keeping a detailed symptom diary, noting patterns in pain and any correlating activity or dietary intake; this information can be invaluable for specialists. Since you’ve exhausted many conventional paths, a multidisciplinary approach involving a team of specialists might offer the best path forward.