Clinical guidelines for interstitial cystitis/bladder pain syndrome

Area of Science:

• Urology
• Clinical Medicine
• Pathology

Background:

• Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic condition causing pelvic pain and urinary symptoms.
• Previous guidelines lacked clear differentiation between subtypes of IC/BPS.
• Hypersensitive bladder symptoms characterize the condition.

Purpose of the Study:

• To update clinical guidelines for IC/BPS and related conditions.
• To clearly define and differentiate between Hunner-type IC/BPS and bladder pain syndrome (BPS).
• To guide distinct diagnostic and therapeutic strategies for IC/BPS subtypes.

Main Methods:

• Revision of existing clinical guidelines.
• Definition of IC/BPS based on chronic pelvic pain and urinary symptoms without other causes.
• Classification into Hunner-type IC/BPS (with Hunner lesions) and BPS (without Hunner lesions).
• Inclusion of non-Hunner-type IC/BPS with glomerulations/bleeding into BPS.
• Distinction based on cystoscopy, histopathology, and pathophysiology.

Main Results:

• IC/BPS is defined by chronic pelvic pain, bladder pressure/discomfort, and urinary symptoms.
• Two distinct subtypes are identified: Hunner-type IC/BPS and BPS.
• Hunner-type IC/BPS shows severe bladder inflammation and urothelial damage.
• BPS exhibits minimal pathological changes in the bladder.
• Symptoms are similar, but distinct histopathology and pathophysiology warrant separate consideration.

Conclusions:

• The updated guidelines establish clear definitions for IC/BPS subtypes.
• Cystoscopy is crucial for differentiating Hunner-type IC/BPS from BPS.
• Distinct histopathological and pathophysiological profiles necessitate tailored treatment strategies.
• Future research should analyze outcomes separately for Hunner-type IC/BPS and BPS.