Bladder pain syndrome/interstitial cystitis: a reappraisal for the clinician

Bladder pain syndrome--formally known as interstitial cystitis--is a chronic bladder disorder characterized by pelvic pain and urinary irritability symptoms. The physiopathology is still unclear but is thought to involve bladder mucosal injury, inflammation and neurologic dysfunction. It is hard to diagnose this entity due to symptoms that are common to several other pathologies such as chronic pelvic pain, endometriosis, overactive bladder, urinary tract infection, and vulvodynia, and due to the lack of specific findings. A combination of history, physical examination, and diagnostic tools helps the establishment of the diagnosis by ruling out other similar pathologies. Treatment is multimodal and combines behavioral changes, drugs administered orally or intravesically and even surgery for refractory cases.