Optimizing the Diagnosis of Interstitial Cystitis/Bladder Pain Syndrome: An ESSIC Proposal

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a heterogenous symptom syndrome. Patients are often misdiagnosed, and current treatment algorithms do not promote an individualized approach to care. This latest international guideline from International Society for the Study of Interstitial Cystitis (ESSIC) provides a practical framework that all clinicians can use in daily practice to optimize the diagnosis and management of IC/BPS.

An expert working group of the ESSIC held a series of structured meetings throughout 2023 and 2024 to achieve an international consensus on optimizing the diagnosis of IC/BPS. Detailed literature search of the PubMed database from inception until December 2024 was conducted. The nominal group technique, a semi-quantitative structured interview procedure, was used to identify and prioritize the aspects of assessment and diagnosis in which to achieve consensus.

Patients should be managed according to a standardized assessment as presented in this consensus. Cystoscopy is essential in the assessment of this condition, to exclude other conditions that may be the cause of the patient's symptoms and to classify patients into subtypes that can help to guide a personalized treatment approach. Cystoscopy features should be reported using the standardized ESSIC reporting tool. Bladder biopsy should be reported according to the ESSIC histological criteria.

The diagnosis of IC/BPS requires specialist assessment. Cystoscopy and bladder biopsy should be performed by specialists in this field using the standardized ESSIC reporting criteria presented in this consensus document. The aim is to subtype patients into well-defined groups so that treatment can be individualized with the aim of improving outcomes for this debilitating condition.