From the Research
Diagnosis of Interstitial Cystitis (IC)/Bladder Pain Syndrome (BPS)
- The diagnosis of IC/BPS is still not clearly understood and is often diagnosed by exclusion 1
- There are no "gold standards" in the diagnosis or detection of IC/BPS, and several etiological theories have been investigated to find new diagnostic strategies and potential biomarkers 2
- The definition and diagnostic criteria for IC/BPS have been established, but the histologic findings are neither specific for diagnosis nor correlated with symptoms 1
- The diagnosis of IC/BPS is often based on the patient's symptoms, including bladder discomfort, urinary frequency, urgency, and pelvic pain 1, 3
Treatment of Interstitial Cystitis (IC)/Bladder Pain Syndrome (BPS)
- The treatment of IC/BPS is often personalized and progressive, starting with conservative options and advancing to more invasive and combined treatments 4
- Behavioral changes, such as dietary modifications and bladder training, are often the first line of treatment 4, 5
- Oral medications, intravesical instillations, and procedures such as hydrodistension may also be used to treat IC/BPS 4, 3, 5
- The treatment of IC/BPS may involve a multidisciplinary team to manage a variety of symptoms, including pelvic floor muscle management and bladder-directed therapies 5
- The American Urological Association guidelines recommend a stepwise approach to treating IC/BPS, separating patients with Hunner lesion interstitial cystitis (HL IC) from those with non-Hunner lesion interstitial cystitis and bladder pain syndrome (N-HL IC/BPS) 5
Pathophysiology of Interstitial Cystitis (IC)/Bladder Pain Syndrome (BPS)
- The pathophysiology of IC/BPS is poorly understood, but theories include chronic inflammation, autoimmune dysregulation, bacterial cystitis, urothelial dysfunction, and deficiency of the glycosaminoglycan (GAG) barrier 3
- Oxidative stress is implicated in the pathogenesis of IC/BPS, with reactive oxygen species impairing bladder function via multiple molecular mechanisms 3
- Further research is necessary to fully understand the role of oxidative stress in the pathways driving IC/BPS pathogenesis 3