Ep 22: When the bladder is painful, the 'UTI' isn't always a UTI, and prostaglandins are hot sauce for the pelvic floor with Urogynaecologist A/Prof Tanaka Dune

Why do so many people with pelvic pain feel like they have constant UTIs… even when the tests keep coming back negative?In this episode, we sit down with urogynecologist and pelvic floor expert A/Prof Tanaka Dune to unpack the incredibly complex world of bladder pain, urgency, frequency, pelvic floor dysfunction and the nervous system.We talk about:• why bladder pain is so often misunderstood• the overlap between pelvic floor tension, endometriosis, bowel symptoms and bladder symptoms• what urogynecologists actually do• why some people may have “UTI symptoms” without a standard urine test showing infection• the emerging science around the bladder microbiome• interstitial cystitis/bladder pain syndrome• how stress, trauma, posture, gait, back pain and the pelvic floor all connect• common bladder irritants including caffeine, alcohol and carbonated drinks• why pelvic floor exams can be such a lightbulb moment for patients• and the surprisingly powerful role of mirrors in helping women reconnect with and understand their anatomyTanaka brings a deeply compassionate and systems-based approach to pelvic pain care, and this conversation completely shifts the way you think about the bladder.This episode is for anyone living with bladder symptoms, recurrent “UTIs”, pelvic pain, painful sex, urgency/frequency, or clinicians wanting a better framework for understanding these presentations.You can find A/Prof Tanaka Dune online as “Dr Pelvic Floor”.Endo Untangled is hosted by Dr. Alecia Macrow and Cherie Noble.New episodes released fortnightly.