[Interstitial cystitis/painful bladder syndrome: a comprehensive review of the current literature]

Interstitial cystitis/painful bladder syndrome (IC/PBS) presents as a pelvic pain condition associated with urinary urgency and frequency. These symptoms significantly impair the patient's quality of life. The prevalence of IC/PBS is 0.5% in the general western population and is nine times more frequent in women. The average age for presentation is 42 years. The etiology is as yet not obvious. The current acceptable theory is injury or dysfunction of the glycosaminoglycan layer that covers the urothelium. Abnormal diffusion of toxins from the urine to the submucosa leads to neurogenic inflammation, pain and fibrosis. The definition of the syndrome is not yet solid and was changed several times since it was first described more than one hundred years ago. Since the diagnosis of IC/PBS is quite complex and furthermore, the awareness is low, the average time from presentation to diagnosis is 7 years. Early treatment provides better outcomes. Many types of methods were described but most of them were not evaluated in well designed randomized controlled studies. Currently, there is no one single treatment that provides good outcomes to every patient. Therefore, the treatment of patients with IC/PBS is challenging and requires a multidisciplinary approach. in this manuscript we review the current literature and describe the problematic diagnosis and the challenging treatment of IC/PBS. Our main objective is to educate and provide awareness of this entity to the general physician. Hopefully, this will result in early diagnosis, saving unnecessary tests and pain to the patients.