Genomics and Histopathology in Interstitial Cystitis/Bladder Pain Syndrome.

Area of Science:

• Urology
• Pathology
• Pain Medicine

Background:

• Interstitial cystitis/bladder pain syndrome (IC/BPS) is a complex condition requiring updated diagnostic and phenotyping strategies.
• Histopathology plays a crucial role in understanding the distinct subtypes of IC/BPS.

Purpose of the Study:

• To establish global consensus on the histopathology of interstitial cystitis/bladder pain syndrome (IC/BPS).
• To differentiate between Hunner lesion disease (HLD) and non-Hunner lesion disease (non-HLD) based on histological and molecular findings.

Main Methods:

• Narrative review of existing literature and consensus discussions.
• Analysis of histological and molecular characteristics of HLD and non-HLD.

Main Results:

• Hunner lesion disease (HLD) is characterized by urothelial denudation and significant subepithelial chronic inflammation with B-cell infiltration.
• Non-Hunner lesion disease (non-HLD) exhibits subtle inflammatory changes with intact urothelium and may involve systemic neurophysiological dysfunction.
• Distinct molecular and histological profiles differentiate HLD from non-HLD.

Conclusions:

• HLD and non-HLD represent distinct disease entities.
• HLD is an inflammatory condition of the bladder, whereas non-HLD may be associated with systemic neurophysiological disorders.
• These distinctions are vital for accurate phenotyping, diagnosis, and biomarker development in IC/BPS.