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Pathogenesis, clinical features, and diagnosis of interstitial cystitis/bladder pain syndrome

Author
J Quentin Clemens, MD, FACS, MSCI
Section Editor
Michael P O'Leary, MD, MPH
Deputy Editor
Kristen Eckler, MD, FACOG

INTRODUCTION

Chronic bladder pain can be a debilitating condition that impacts quality of life [1,2]. The pathophysiology of chronic bladder pain is not well understood and it is likely that such symptoms represent more than one underlying etiology. Interstitial cystitis/bladder pain syndrome (IC/BPS) is a diagnosis that applies to patients with chronic bladder pain in the absence of other etiologies of the symptoms. Identification of patients who meet diagnostic criteria for IC/BPS allows for treatment with the goal of providing symptomatic relief. This condition often coexists with other chronic pain syndromes (eg, fibromyalgia, irritable bowel syndrome).

The pathogenesis, clinical features, and diagnosis of interstitial cystitis/bladder pain syndrome will be discussed here. Management of this condition is reviewed separately. (See "Management of interstitial cystitis/bladder pain syndrome".)

TERMINOLOGY

Chronic bladder pain in the absence of an identifiable etiology has historically been called interstitial cystitis. This term is a misnomer, however, since there is no clear evidence that bladder inflammation (cystitis) is involved in the etiology or pathophysiology of the condition, nor is there evidence that the condition is associated with abnormalities of the interstices of the bladder.

The current understanding is that patients with these symptoms have a chronic pain condition of the bladder, analogous to other poorly understood chronic pain conditions such as fibromyalgia or irritable bowel syndrome. As such, there has been a movement to rename the condition painful bladder syndrome or bladder pain syndrome. However, considerable previous efforts have been devoted to recognizing “interstitial cystitis” as a legitimate, disabling medical condition and, therefore, the term has been retained in contemporary use in order to maintain continuity. This topic review will use the term “interstitial cystitis/bladder pain syndrome.”

The definition of IC/BPS is discussed below. (See 'Diagnosis' below.)

                        

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Literature review current through: Nov 2016. | This topic last updated: Fri Jul 24 00:00:00 GMT+00:00 2015.
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