Advances in Diagnosis and Treatment of Interstitial Cystitis/Painful Bladder Syndrome

Abstract

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a prevalent chronic condition that can be challenging not only to diagnose but also to treat. We review recent diagnostic markers and therapies for IC/BPS from non-medication-based therapies, oral therapies, intravesical therapies, and surgical treatments.

Deep Dyspareunia in Endometriosis: Role of the Bladder and Pelvic Floor

“…We also found that bladder/pelvic floor tenderness was associated with deep dyspareunia, independent of painful bladder syndrome, suggesting that myofascial origin or central sensitization may also be important in tenderness of these areas [15]. Myofascial pain could involve tender trigger points in the levator ani or anterior vaginal wall [20,21] due to hyperactive nerve firing within the skeletal muscle reflex arc due to muscle fibre trauma [20] [23]. Sensitization could manifest as hyperalgesia and allodynia [24,25] in normally non-tender structures (e.g., the bladder and pelvic floor); this could occur by amplification of central nervous system nociceptive pathways, or by viscero-visceral convergence or viscero-somatic convergence at the spinal cord that links gynecologic pain to other visceral (e.g.…”

Urine nerve growth factor (NGF) level, bladder nerve staining and symptom/problem scores in patients with interstitial cystitis

“…1 Although there are numerous theories in regard to IC/BPS etiology, its physiopathology still remains unclear and there is a lack of certain treatment. 2 Various diagnostic tests and attempts at treatment lead to a substantial economic burden as well as patient distress. Thus, using biomarkers in diagnosis has garnered greater interest in the last decade.…”

Reviewing Interstitial Cystitis Models and Treatments: A Focus on the Urothelium

“…Since Hunner's IC characterization was performed, numerous cases of IC with no evidence of bladder wall lesions were confirmed (10). As already said, ICs with mast cells invasion and inflammation, as well as IC due to sensory nerve sensitization show both the presence and the absence of Hunner's ulcers, but their incidence is low.…”

“…This suggested the presence of at least two clinical conditions, ulcerative and non-ulcerative IC, depending on the presence or absence of Hunner's ulcers. Ulcerative IC was most common in older people, presenting with increased day and night-time urinary frequency, histological changes and diffuse bladder inflammation; by contrast, non-ulcerative IC was commonly associated with diffuse and often systemic syndromes, such as fibromyalgia (FM), chronic fatigue syndrome (CFS), irritable bowel syndrome (IBS), chronic pelvic pain (CPP), temporomandibular joint disorder (TMD), migraine, vulvodynia, low back pain, sicca syndrome, allergies, asthma, anxiety, and depression and can be alternatively categorized as a functional somatic syndrome (10). The differentiation of the two subtypes was also supported at least in part by the fact that patients with the ulcerative sub-type responded quite well to local therapies while in contrast patients with the non-ulcerative responded less well.…”