A Biopsychosocial Framework for Overactive Bladder Syndrome & Bladder Pain Syndrome

Overview

Overactive bladder (OAB) and bladder pain syndrome (BPS) are often treated as primarily peripheral or organ-based conditions. However, growing evidence suggests that for many patients, these symptoms are driven by central sensitization and influenced by psychological and social factors.

In this course, Carolyn Vandyken presents a clinically grounded, evidence-informed exploration of how a biopsychosocial framework can be applied to OAB, BPS, and interstitial cystitis (IC). By reframing urgency and pain as outputs of central nervous system processing, this course challenges traditional diagnostic silos and offers clinicians a more integrated, patient-centered approach to assessment and treatment.

Through research review, clinical reasoning, and an in-depth case study, participants gain practical tools to identify centrally mediated bladder symptoms and implement individualized, interdisciplinary care strategies.

Learning Objectives

By the end of this course, participants will be able to:

1. Explain the role of central sensitization in overactive bladder and bladder pain syndromes

2. Differentiate between OAB, BPS, and interstitial cystitis based on symptom presentation and clinical features

3. Identify key biological, psychological, and social contributors to bladder-related symptoms

4. Use validated screening tools to objectively assess psychosocial factors and central sensitization

5. Apply a biopsychosocial framework to clinical decision-making and treatment planning

6. Begin to develop individualized, interdisciplinary strategies for patients with complex or refractory OAB presentations

Audience

This course is designed for healthcare professionals working with pelvic health and chronic pain populations, including:

• Physiotherapists / Physical Therapists

• Pelvic health clinicians

• Urologists and gynecologists

• Occupational therapists

• Psychologists and mental health professionals

• Other clinicians managing patients with bladder dysfunction or chronic pelvic conditions

Why This Course Matters

Many patients with overactive bladder do not respond fully to conventional treatments focused solely on bladder mechanics. This course addresses a critical gap by:

• Positioning urgency and pain as brain-mediated experiences, similar in mechanism

• Highlighting the high prevalence of comorbid conditions (e.g., IBS, fibromyalgia, migraine) and psychological distress in OAB populations

• Providing clinicians with a clear framework to recognize when central sensitization is driving symptoms

• Encouraging objective assessment rather than reliance on clinical intuition alone

By adopting a biopsychosocial lens, clinicians can improve diagnostic accuracy, tailor interventions more effectively, and achieve better long-term outcomes for patients with complex bladder presentations.

Clinical Application: Case Example

The course includes a detailed case study of Barbara, a 59-year-old woman initially diagnosed with interstitial cystitis and later reclassified as having OAB with significant psychological distress following a major life stressor. Through a combination of nervous system regulation, stress management strategies, pelvic floor assessment, and social reconnection, Barbara experienced marked symptom resolution within two months.

This case demonstrates how addressing psychological and social drivers alongside biological factors can lead to meaningful and sustained clinical improvement.