Pathophysiology and potential multimodal therapeutic strategies for IC/BPS

Area of Science:

• Urology
• Pain Medicine
• Immunology

Background:

• Interstitial cystitis/bladder pain syndrome (IC/BPS) presents with diverse clinical symptoms and presentations.
• The etiology of IC/BPS is not well-defined, contributing to a lack of effective treatments.
• Multiple factors, including urothelial dysfunction, mast cell activation, and neurogenic inflammation, are implicated in IC/BPS.

Purpose of the Study:

• To propose a rational algorithm for concomitant multimodal therapy in IC/BPS.
• To address the need for a defined therapeutic strategy for this complex bladder disorder.
• To guide clinicians in managing the varied pathological mechanisms of IC/BPS.

Main Methods:

• Review of current understanding of IC/BPS pathophysiology.
• Analysis of existing non-pharmacological, medical, and intravesical therapies.
• Development of a structured algorithm for multimodal treatment approaches.

Main Results:

• The study proposes a multimodal therapeutic strategy based on potential pathological mechanisms.
• An algorithm for concomitant multimodal therapy for IC/BPS has been developed.
• The proposed algorithm aims to provide a rational approach to managing IC/BPS.

Conclusions:

• A structured, multimodal therapeutic approach is suggested for IC/BPS.
• The proposed algorithm offers a framework for addressing the complexity of IC/BPS.
• Further research is needed to elucidate the efficacy and durability of proposed multimodal therapies.