Diagnosis and Management of Interstitial Cystitis/ Painful Bladder Syndrome

Kim, Young Ho

Abstract

Much has changed in our understanding of the interstitial cystitis/painful bladder syndrome (IC/PBS) over time. The International Continence Society (ICS) prefers the term Painful Bladder Syndrome (PBS) defined as "the complaint of suprapubic pain related to bladder filling, accompanied by other symptoms such as increased daytime and night-time frequency, in the absence of proven urinary infection or other obvious pathology". Interstitial cystitis is a clinical diagnosis primarily based on symptoms of urgency/frequency and pain in the bladder and or pelvis. The pathogenesis of IC is still not completely understood, but it is likely multifactorial. The major etiologic theories include abnormality of the bladder urothelium, bladder mast cell activation, bladder inflammation, and altered bladder innervation. The sensitivity and specificity of urinary markers and the potassium sensitivity test have not been prospectively studied. Antiproliferative factor and Tamm-Horsfall protein are novel tests that may prove to be worthwhile pending future studies. Management includes patient education, dietary and lifestyle counseling, oral therapy, intravesical therapy, and surgery. Recently, the European Society for the Study of Interstitial Cystitis (ESSIC) proposed a new nomenclature and classification system. This article discusses recent data and outlines current concepts of IC/PBS.