Materiały źródłowe

• #1 Interstitial cystitis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/interstitial-cystitis/diagnosis-treatment/drc-20354362

  Diagnosis of interstitial cystitis might include: […] Your health care provider may ask you to describe your symptoms and to keep a bladder diary, recording the volume of fluids you drink and the volume of urine you pass. […] During a pelvic exam, your provider examines your external genitals, vagina and cervix and feels your abdomen to assess your internal pelvic organs. […] A sample of your urine is analyzed for signs of a urinary tract infection. […] Your provider inserts a thin tube with a tiny camera (cystoscope) through the urethra, showing the lining of your bladder. […] During cystoscopy under anesthesia, your provider may remove a sample of tissue (biopsy) from the bladder and the urethra for examination under a microscope. […] Your provider collects a urine sample and examines the cells to help rule out cancer. […] Your provider places (instills) two solutions water and potassium chloride into your bladder, one at a time. […] If you feel noticeably more pain or urgency with the potassium solution than with the water, your provider may diagnose interstitial cystitis.

• #2 Patient education: Diagnosis of interstitial cystitis/bladder pain syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/diagnosis-of-interstitial-cystitis-bladder-pain-syndrome-beyond-the-basics/print

  Interstitial cystitis/bladder pain syndrome (IC/BPS) is a group of symptoms including mild to severe bladder pain and an urgent and/or frequent need to urinate. The disorder can affect women and men but is more common in women. It can be difficult to diagnose and treat because the underlying cause is not well understood. […] The diagnosis of interstitial cystitis/bladder pain syndrome (IC/BPS) is based on a person’s symptoms and examination. A careful medical history, physical examination, and, sometimes, laboratory testing are needed to confirm the diagnosis and also to be sure that another condition (eg, bladder infection or kidney stone) is not the cause of symptoms. There is no single test that can definitively diagnose IC/BPS. […] Physical examination — The physical examination usually includes a complete pelvic examination with a brief rectal examination. Often, patients with IC/BPS have tenderness in the lower abdomen, hips, and buttocks.

• #3 Diagnosis and Treatment of Interstitial Cystitis/Bladder Pain Syndrome – PubMed

  https://pubmed.ncbi.nlm.nih.gov/35536143/

  Purpose: This guideline provides direction to clinicians and patients regarding how to recognize interstitial cystitis/bladder pain syndrome (IC/BPS), conduct a valid diagnostic process, and approach treatment with the goals of maximizing symptom control and patient quality of life while minimizing adverse events and patient burden. […] Methods: An initial systematic review of the literature using the MEDLINE database (search dates 1/1/83-7/22/09) was conducted to identify peer-reviewed publications relevant to the diagnosis and treatment of IC/BPS. […] Results: In contrast to the prior versions, the 2022 updated Guideline no longer divides treatments into first-line through sixth-line tiers. Instead, treatment is categorized into behavioral/non-pharmacologic, oral medicines, bladder instillations, procedures, and major surgery. […] Conclusion: IC/BPS is a heterogeneous clinical syndrome. Even though patients present with similar symptoms of bladder/pelvic pain and pressure/discomfort associated with urinary frequency and strong urge to urinate, there are subgroups or phenotypes within IC/BPS.

• #4 Interstitial Cystitis Workup: Approach Considerations, Cystoscopy, Bladder Biopsy

  https://emedicine.medscape.com/article/2055505-workup

  The diagnosis of interstitial cystitis is most often made when long-standing urinary frequency, urgency, and pelvic pain exist in the absence of a readily identifiable etiology, such as urinary tract infection (UTI). Urinalysis and urine culture are mandatory. A voiding diary is helpful in establishing baseline voiding frequency. […] Cystoscopy is considered by some clinicians to be mandatory in order to diagnose interstitial cystitis However, this is somewhat controversial because of the lack of specific or pathognomonic findings (except perhaps the very rare finding of a Hunner ulcer). […] Urodynamic evaluation is optional, and finding detrusor overactivity or pelvic floor dysfunction may suggest an alternative diagnosis. […] No known radiographic, ultrasonographic, or other imaging findings are specific for interstitial cystitis.

• #5

  https://www.ics.org/committees/standardisation/terminologydiscussions/icbps

  Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS). Persistent or recurrent chronic pelvic pain, pressure or discomfort perceived to be related to the urinary bladder accompanied by at least one other urinary symptom such as an urgent need to void or urinary frequency. Diagnosed in the absence of any identifiable pathology which could explain these symptoms. Interstitial Cystitis/Hunner lesion. Interstitial cystitis with Hunner lesion has the same symptoms as IC/BPS. Identified on the basis of cystoscopic findings. […] Painful bladder syndrome is 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 specific diagnosis and requires confirmation by typical cystoscopic and histological features. In the investigation of bladder pain, it may be necessary to exclude conditions such as carcinoma in situ and endometriosis.

• #6 Diagnosis and Treatment of Interstitial Cystitis/Bladder Pain Syndrome (2022) – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/diagnosis-and-treatment-interstitial-of-cystitis/bladder-pain-syndrome-(2022)

  Diagnosis and Treatment of Interstitial Cystitis/Bladder Pain Syndrome (2022) […] The purpose of this clinical guideline is to provide a clinical framework for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome (IC/BPS), including discussion of treatments that should and should not be offered. […] The basic assessment should include a careful history, physical examination, and laboratory examination to document symptoms and signs that characterize IC/BPS and exclude other disorders that could be the cause of the patients symptoms. Clinical Principle […] Baseline voiding symptoms and pain levels should be obtained in order to measure subsequent treatment effects. Clinical Principle […] Cystoscopy and/or urodynamics should be considered when the diagnosis is in doubt; these tests are not necessary for making the diagnosis in uncomplicated presentations. Expert Opinion

• #7 Diagnosis of Interstitial Cystitis – NIDDK

  https://www.niddk.nih.gov/health-information/urologic-diseases/interstitial-cystitis-bladder-pain-syndrome/diagnosis

  Health care professionals diagnose interstitial cystitis (IC) by ruling out other conditions with similar symptoms. They will use your medical history, a physical exam, and lab and other tests to help diagnose IC. Your health care professional will ask questions about your symptoms and may have you keep a voiding log, also known as a bladder diary. […] Health care professionals may use urinalysis, urine culture, and other tests to help diagnose IC or to rule out other conditions with similar symptoms. […] A health care professional may perform a cystoscopy to help diagnose IC.

• #8 Patient education: Diagnosis of interstitial cystitis/bladder pain syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/diagnosis-of-interstitial-cystitis-bladder-pain-syndrome-beyond-the-basics/print

  If an examination is too uncomfortable, some health care providers recommend that the patient begin a course of treatment for IC/BPS without further testing. If improvement is not seen, it may be necessary to perform more testing to confirm the diagnosis. […] Laboratory tests — Most clinicians perform a urine test to ensure that a person’s symptoms are not related to another condition, such as a kidney stone or bladder infection. […] Cystoscopy is a test that lets a doctor examine the inside of the bladder. Cystoscopy is not required to diagnose IC/BPS but may be recommended in certain situations.

• #9 Urology & Continence Care Today | May 2025

  https://www.ucc-today.com/journals/issue/launch-edition/article/interstitial-cystitis-facilitating-earlier-diagnosis-and-treatment-ucct

  Physical examination often does not normally reveal any abnormalities specific to IC. […] There is no universally accepted criteria for diagnosis. […] No specific tests are currently available to confirm the diagnosis. […] Multiple investigations may be undertaken and may be useful in eliminating a differential diagnosis. […] Cystoscopy will confirm the presence or absence of Hunners ulcers and glomerulations and will also confirm or exclude bladder cancer as a cause for the patients symptoms. […] Following initial assessment and history-taking, with the exception of urinalysis, all other investigations are done in the secondary care setting, following referral to a urologist. […] Urinalysis: a urine dipstick if abnormal will identify the need for further testing and if findings suggest urinary tract infection (UTI) a sample should be sent to the laboratory for culture and sensitivity.

• #10 Interstitial Cystitis/Painful Bladder Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0515/p1175.html

  Interstitial cystitis/painful bladder syndrome affects more than 1 million persons in the United States, but the cause remains unknown. […] Tests and tools commonly used to diagnose interstitial cystitis/painful bladder syndrome include specific questionnaires developed to assess the condition, the potassium sensitivity test, the anesthetic bladder challenge, and cystoscopy with hydrodistension. […] There is no reference standard test for the diagnosis of interstitial cystitis/painful bladder syndrome. Adding to the complexity of diagnosis, numerous conditions have overlapping symptoms. […] The symptoms of interstitial cystitis/painful bladder syndrome often mimic urinary tract infection, but cultures are negative. […] There are two symptom screening questionnaires available for use in office practice: the O’Leary-Sant Symptom and Problem Index and the Pelvic Pain and Urgency/Frequency Symptom Scale (PUF).

• #11 Interstitial cystitis: Simplified diagnosis and treatment

  https://www.contemporaryobgyn.net/view/interstitial-cystitis-simplified-diagnosis-and-treatment

  Interstitial cystitis/bladder pain syndrome (IC/BPS) is now recognized as a common etiology in women with chronic pelvic pain. […] The true accuracy of this data is limited by the varying definitions of IC/BPS and the underdiagnosis of patients. […] Diagnosing and establishing a treatment plan, however, can be daunting for practitioners inexperienced in treating patients with IC/BPS. […] Patients with frequent symptoms of urinary tract infection (UTI) but repeated negative cultures should be evaluated for IC. It is also important to consider screening all patients presenting with subacute or chronic pelvic pain for IC. […] Two validated screening tools are available, the Pelvic Pain and Urgency/Frequency (PUF) patient symptom scale and the OLeary-Sant IC symptom and problem index. […] Higher screening scores correlate most closely with the diagnosis of IC.

• #12 Broaden Horizons: The Advancement of Interstitial Cystitis/Bladder Pain Syndrome

  https://www.mdpi.com/1422-0067/23/23/14594

  On the basis of the diagnosis of exclusion, the diverse present diagnostic and therapeutic procedures are undergoing a transition from a single approach to multimodal strategies targeting different potential phenotypes recommended by different guidelines. […] Since there are no sensitive and specific biomarkers for the diagnosis of IC/BPS, its diagnosis still poses challenges. […] Different from that of 30 years ago, the diagnosis of IC/BPS does not rely on strict diagnostic criteria; rather, a diagnosis of exclusion and the recognition of symptoms of IC/BPS are key. […] A detailed history is vital for obtaining a diagnosis. […] The history of pelvic surgery and other autoimmune diseases is also helpful for diagnosis. […] CUA, EAU, ICI-RS, and BJOG recommend symptom scales used as tools to assist diagnosis, and there are five commonly used scales (i.e., the Interstitial Cystitis Symptom Index (ICSI); the Interstitial Cystitis Problem Index (ICPI); the Wisconsin Interstitial Cystitis scale (UW-IC scale); the Pain, Urgency, Frequency score (PUF score); and the Bladder Pain/IC Symptom Score (BPIC-SS)).

• #13 The Evaluation and Management of Interstitial Cystitis/Bladder Pain Syndrome – European Medical Journal

  https://www.emjreviews.com/urology/article/the-evaluation-and-management-of-interstitial-cystitis-bladder-pain-syndrome/

  It is now clear that clinicians must be astute, evaluate triggers that can impact the patients symptoms, and use a multimodal approach to improve quality of life. […] A careful history and physical exam are critical in patients with symptoms of IC/BPS. […] Voiding diaries can be filled out by patients to quantify urinary symptoms. […] Validated questionnaires are commonly used to quantify symptoms and assess changes during treatment, but questionnaires should not be used alone for the diagnosis of IC/BPS. […] Urinalysis and urine culture must be checked to screen for infection or microscopic haematuria. […] Haematuria increases the suspicion of HLIC or another urological pathology and should prompt cystoscopy to visually evaluate the bladder and urine cytology to screen for cancer.

• #14 Painful Bladder Syndrome (Interstitial Cystitis) | Doctor

  https://patient.info/doctor/interstitial-cystitispainful-bladder-syndrome-pro

  Painful bladder syndrome (PBS) is a chronic condition of unknown cause. The common symptoms include urinary urgency, frequency, nocturia and suprapubic or pelvic pain without any known aetiological factor. […] The American Urological Association, European Association of Urology and International Consultation on Incontinence have published symptom-based diagnostic criteria for PBS. All include the symptoms of pain related to the bladder, at least one other urinary symptom, absence of identifiable causes and minimum duration of symptoms of six weeks to six months. […] The diagnosis and management of this syndrome may be difficult in some patients. The diagnosis of IC/PBS is usually based on a thorough assessment and exclusion of other causes. […] A bladder diary (frequency volume chart) should be completed. A food diary may also be useful, to identify if specific foods cause a flare-up of symptoms. […] Urinalysis and midstream urine for urine cultures: rule out urinary tract infection, including tuberculosis. […] Urodynamic studies: there are no specific findings but pain with bladder filling that reproduces the symptoms is very supportive of a diagnosis of IC/PBS. […] Most cases need cystoscopy to exclude bladder cancer. Hunner’s ulcers (reddened mucosal areas often associated with small vessels radiating towards a central scar, sometimes covered by a small clot or fibrin deposit) may be seen in 10-50%.

• #15 Interstitial Cystitis/Bladder Pain Syndrome – Urogynecology & Pelvic Health | UCLA Health

  https://www.uclahealth.org/medical-services/womens-pelvic-health/conditions-treated/interstitial-cystitisbladder-pain-syndrome

  Interstitial cystitis/ Bladder pain syndrome (IC/BPS) is a complex, chronic disorder characterized by bladder pain often with urinary frequency and urgency. […] Because there is no definitive test to diagnose BPS/IC, and because symptoms of BPS/IC are similar to other urinary disorders, a variety of diagnostic tests and procedures may be necessary. […] In addition to a complete medical history and physical examination, diagnostic procedures for BPS/IC may include the following: […] Urinalysis: Laboratory examination of urine for various cells and chemicals, such as red blood cells, white blood cells, infection, or excessive protein. […] Urine culture: to definitively check for infection […] Cystoscopy: an examination in which a scope, a flexible tube and viewing device, is inserted through the urethra to examine the bladder and urinary tract for structural abnormalities or obstructions, such as tumors or stones.

• #16

  https://www.beaumont.org/conditions/interstitial-cystitis

  Because there is no definitive test to diagnose interstitial cystitis, and symptoms are similar to other disorders, a complete history, and possibly a variety of diagnostic tests and procedures, may be necessary. […] Diagnostic procedures for interstitial cystitis may include the following: […] urinalysis: laboratory examination of urine for various cells and chemicals, such as red blood cells, white blood cells, infection or excessive protein […] urine culture and cytology […] pelvic and pelvic floor muscle exam […] cystoscopy (also called cystourethroscopy): an examination in which a scope, a flexible tube and viewing device, is inserted through the urethra to examine the bladder and urinary tract for structural abnormalities or obstructions, such as tumors or stones […] bladder wall biopsy: a procedure in which tissue samples are removed (with a needle or during surgery) from the body for examination under a microscope; to determine if cancer or other abnormal cells are present […] laboratory examination of prostate secretions (in men).

• #17 Diagnosing interstitial cystitis: Tests and when to seek help

  https://www.medicalnewstoday.com/articles/how-is-interstitial-cystitis-diagnosed

  A cystoscopy is a diagnostic procedure in which a urologist inserts a thin tube called a cystoscope into a persons urethra. […] This tool allows the urologist to view the bladder and urethra to look for inflammation or swelling, bladder ulcers, and signs of infection. […] A bladder wall biopsy is a diagnostic procedure in which a urologist removes a small sample of the bladder tissue for analysis under a microscope. […] A biopsy is not necessary to confirm a diagnosis of IC/BPS, but it can help rule out bladder cancer. […] Healthcare professionals may ask males who are experiencing symptoms of IC/BPS to undergo an examination of prostate secretions to rule out prostatitis an infection and inflammation of the prostate gland that can have similar symptoms to IC/BPS. […] Potassium chloride sensitivity testing (PST) is a controversial diagnostic method for IC/BPS.

• #18 Interstitial Cystitis (IC): Symptoms, Causes, Treatment

  https://www.webmd.com/urinary-incontinence-oab/interstitial-cystitis

  Interstitial Cystitis Diagnosis: Theres no test for interstitial cystitis. If you go to your doctor complaining about bladder pain along with frequency and the urgency to pee, the next step is to rule out other conditions. […] These tests can rule out other conditions: Urinalysis and urine culture. Youll be asked to pee in a cup. Itll be sent to a lab to check for infection. […] Cystoscopy. A thin tube with a camera is used to see the inside of the bladder and urethra. This is usually done only if there is blood in your pee or if treatment doesnt help. […] Interstitial cystitis has no known cause. It may have multiple causes, including autoimmune problems, allergies, inflammation, or others.

• #19 Interstitial Cystitis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/15735-interstitial-cystitis-painful-bladder-syndrome

  Interstitial cystitis/bladder pain syndrome is a condition that causes long-term pain or discomfort in your bladder and abdominal area, along with urinary frequency and urgency. […] Healthcare providers and medical researchers dont completely understand what causes interstitial cystitis/bladder pain syndrome. […] There arent any specific tests to diagnose interstitial cystitis/bladder pain syndrome. However, a healthcare provider will order tests to rule out other infections or conditions. […] A healthcare provider may ask you to record your symptoms in a journal or diary. […] A provider will prescribe antibiotics to treat an infection. A provider may diagnose IC/BPS if your pee is sterile after treatment, but you still have symptoms. […] A provider will examine the inside of your urethra and bladder with a thin, lighted tube with an eyepiece on one end (cystoscope) to help rule out bladder cancer.

• #20 Diagnosis and Treatment of Interstitial Cystitis/Bladder Pain Syndrome (2022) – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/diagnosis-and-treatment-interstitial-of-cystitis/bladder-pain-syndrome-(2022)

  Cystoscopy should be performed in patients in whom Hunner lesions are suspected. Expert Opinion […] Treatment decisions should typically be made after shared decision-making, with the patient informed of the risks, potential benefits, and alternatives. Except for patients with Hunner lesions, initial treatment should be nonsurgical. Expert Opinion […] Efficacy of treatment should be periodically reassessed, and ineffective treatments should be stopped. Clinical Principle […] Multimodal pain management approaches (e.g., pharmacological, stress management, manual therapy if available) should be initiated. Pain management should be continually assessed for effectiveness because of its importance to quality of life. If pain management is inadequate, then consideration should be given to a multidisciplinary approach and the patient referred appropriately. Clinical Principle

• #21 Interstitial Cystitis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/15735-interstitial-cystitis-painful-bladder-syndrome

  A provider may perform cystoscopy with bladder hydrodistension. […] A provider may recommend surgery if you have severe IC/BPS symptoms and dont respond to other treatments. […] Schedule an appointment with a healthcare provider if you have symptoms of interstitial cystitis/bladder pain syndrome. A provider will order tests to rule out infections or other conditions that may cause IC/BPS symptoms.

• #22 Interstitial Cystitis – Symptoms, causes, treatment | National Kidney Foundation

  https://www.kidney.org/kidney-topics/interstitial-cystitis

  How is the diagnosis made? The doctor must make sure that other diseases are not causing the symptoms. […] To make the diagnosis, your doctor usually begins with a general examination, including a pelvic exam and urinalysis. The urine is usually normal, with no signs of bacterial infection. For a definite diagnosis of IC, a cystoscopic examination is usually necessary. In this procedure, the patient is put under general anesthesia, the bladder is distended (stretched) with water and the doctor uses a telescopic device (cystoscope) to look inside the bladder. The doctor may also take a biopsy (a small sample of tissue) from your bladder to help exclude other conditions.

• #23 Bladder Pain Syndrome and Interstitial Cystitis: Definition and Etiology

  https://www.urology-textbook.com/interstitial-cystitis.html

  Urine cytology: to exclude bladder cancer (especially carcinoma in situ). […] Cystoscopy should be performed under general anesthesia in patients with bladder pain syndrome. The bladder is distended under vision with a pressure of 80100 cm H2O for 2 min; the bladder capacity is measured. […] The sensitivity and specificity of the cystoscopic findings are controversial (see above). A quadrant bladder biopsy is done to exclude bladder cancer (carcinoma in situ). […] Intravesical KCl (0.4 M) produces pain in many patients with bladder pain syndrome—the potassium chloride test claims to indicate abnormal epithelial permeability. […] Urodynamic studies are useful in unclear cases with bladder pain syndrome, especially to exclude an overactive bladder. Cystometry usually reveals pain on bladder filling and a normal detrusor function.

• #24 Diagnosis and Treatment of Interstitial Cystitis/Bladder Pain Syndrome (2022) – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/diagnosis-and-treatment-interstitial-of-cystitis/bladder-pain-syndrome-(2022)

  The IC/BPS diagnosis should be reconsidered if no improvement occurs after multiple treatment approaches. Clinical Principle […] Cystoscopy under anesthesia with short-duration, low-pressure hydrodistension may be undertaken as a treatment option. Option (Evidence Strength: Grade C) […] If Hunner lesions are present, then fulguration (with electrocautery) and/or injection of triamcinolone should be performed. Recommendation (Evidence Strength: Grade C) […] Intradetrusor onabotulinumtoxin A may be administered if other treatments have not provided adequate improvement in symptoms and quality of life. Patients must be willing to accept the possibility that intermittent self-catheterization may be necessary. Option (Evidence Strength: Grade C) […] A trial of neuromodulation may be performed if other treatments have not provided adequate symptom control and quality of life improvement. If a trial of nerve stimulation is successful, then the permanent neurostimulation device may be implanted. Option (Evidence Strength: Grade C)

• #25 Diagnosis and Treatment of Interstitial Cystitis/Bladder Pain Syndrome (2022) – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/diagnosis-and-treatment-interstitial-of-cystitis/bladder-pain-syndrome-(2022)

  Major surgery (substitution cystoplasty, urinary diversion with or without cystectomy) may be undertaken in carefully selected patients with bladder-centric symptoms, or in the rare instance when there is an end-stage small fibrotic bladder, for whom all other therapies have failed to provide adequate symptom control and quality of life improvement. Option (Evidence Strength: Grade C) […] Long-term oral antibiotic administration should not be offered. Standard (Evidence Strength: Grade B) […] Intravesical instillation of bacillus Calmette-Guerin should not be offered outside of investigational study settings. Standard (Evidence Strength: Grade B) […] High-pressure, long-duration hydrodistension should not be offered. Recommendation (Evidence Strength: Grade C) […] Systemic (oral) long-term glucocorticoid administration should not be offered. Recommendation (Evidence Strength: Grade C)

• #26 Interstitial Cystitis | Loma Linda University Health

  https://lluh.org/conditions/interstitial-cystitis

  Interstitial cystitis is not a urinary tract infection, and it cannot be specifically diagnosed. Instead, it is a diagnosis of exclusion. In other words, it can only be diagnosed after other conditions have been ruled out. […] Your diagnosis of exclusions will begin with a history and a physical exam. You will be tested for a number of conditions, such as an infection, kidney disease, bladder stones or bladder cancer. […] A fairly common finding in those who are diagnosed with interstitial cystitis from a cystoscopy is reddened patches known as Hunners ulcers. However, Hunners ulcers dont have to be present to make a diagnosis of interstitial cystitis. […] At Loma Linda Health, effective treatment starts with a precise diagnosis, and we are experts in finding the root cause of these disorders.

• #27 Bladder Pain Syndrome (BPS) | Melbourne Bladder Clinic

  https://bladderclinic.com.au/conditions/bladder/bladder-pain-syndrome-bps

  BPS / IC is a diagnosis of exclusion; meaning that other causes of these symptoms such as infection, overactive bladder (OAB), cancer, radiation or other forms of cystitis must be ruled out first. […] Assessment should include a careful history, physical examination and investigations. […] A urine test is done to exclude a urinary tract infection. […] Cystoscopy and urodynamics are considered as an aid to diagnosis, and are not necessary in uncomplicated cases. […] A cystoscopy (inspection of the inside of the bladder with a tubelike camera) can be done to look for features of IC, such as bladder ulcers or small bleeding points seen after distension of the bladder with sterile fluid. […] During the cystoscopy, a bladder biopsy can also be done to look for inflammatory cells in parts of the bladder wall. […] Urodynamics can look for bladder outlet obstruction from failure to relax the pelvic floor during voiding.

• #28 Interstitial Cystitis Diagnosis & Treatment – NYC | ColumbiaDoctors

  https://www.columbiadoctors.org/specialties/urology/our-services/urinary-disorders/conditions-we-treat/interstitial-cystitis

  Interstitial cystitis (IC), also known as painful bladder syndrome or frequency-urgency-dysuria syndrome, is a complex, chronic disorder characterized by an inflamed or irritated bladder wall. […] Physicians diagnose IC by excluding any other condition that might be producing symptoms –urinary tract infections, sexually transmitted diseases, vaginal infections, bladder cancer and inflammation, tuberculosis cystitis, kidney stones, and endometriosis. To exclude these other conditions, urologists may perform simple blood and urine tests and cystoscopy to look at the inner walls of the bladder. They may stretch the bladder to capacity with fluid (called hydrodistension) while the patient is under general anesthesia and then inspect the bladder for areas of inflammation and cracks that bleed. […] They may examine the bladder for Hunner’s ulcers, a specific type of inflammation that is strongly associated with IC, but is rare.

• #29 Interstitial Cystitis/Bladder Pain Syndrome – Urogynecology & Pelvic Health | UCLA Health

  https://www.uclahealth.org/medical-services/womens-pelvic-health/conditions-treated/interstitial-cystitisbladder-pain-syndrome

  In some women with IC/BPS an ulcer or Hunner’s lesion may be identified in the bladder. […] Bladder biopsy: a procedure in which tissue samples are removed (with a needle or during surgery) from the body for examination under a microscope to determine if abnormal pathology is present. […] This is done at the time of cystoscopy when an abnormality in the bladder is seen.

• #30 Interstitial Cystitis/Painful Bladder Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0515/p1175.html

  The potassium sensitivity test is widely used to aid in the diagnosis of interstitial cystitis/painful bladder syndrome, although it is not universally accepted. […] An anesthetic solution such as buffered lidocaine (Xylocaine) can be instilled in a symptomatic patient. Pain relief suggests that the bladder is the source of the pain. […] Cystoscopy with hydrodistension under anesthesia has been widely used for diagnosis of interstitial cystitis/painful bladder syndrome based on the 1987 NIDDK diagnostic criteria. […] Bladder biopsies are not performed routinely in the United States, although they are widely used to diagnose interstitial cystitis/painful bladder syndrome in Europe.

• #31 Interstitial Cystitis: Urgency and Frequency Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/1001/p1199.html

  After the above evaluations are completed, confirmation of the diagnosis of interstitial cystitis depends on cystoscopic findings. Hydrodistention of the bladder is often performed during cystoscopy under general anesthesia. […] Biopsies are indicated in patients with suspected interstitial cystitis to exclude specific bladder pathology such as carcinoma, dysplasia or tuberculosis; to confirm bladder wall inflammation; and to identify subgroups of patients, such as those with excessive mast cells or eosinophils. […] Urodynamic studies are not specifically diagnostic of interstitial cystitis. Radiographic studies, such as intravenous pyelography or voiding cystourethrography, are seldom indicated in the evaluation of patients with suspected interstitial cystitis. […] The symptoms of interstitial cystitis typically worsen in the week before menstruation in contrast to the symptoms of endometriosis, which are worse during menses. […] Urinary frequency in patients with interstitial cystitis averages 16 times per day but can be as much as 40 times per day.

• #32 Interstitial Cystitis Workup: Approach Considerations, Cystoscopy, Bladder Biopsy

  https://emedicine.medscape.com/article/2055505-workup

  No pathognomonic histologic findings exist for interstitial cystitis, although some authors have found increased numbers of mast cells in the detrusor muscle or submucosa in affected individuals. […] Some authors have found that certain subgroups of patients with interstitial cystitis have increased urothelial permeability to certain intravesical constituents. […] Urinalysis results are usually normal. […] Urodynamic studies are not part of the routine evaluation for interstitial cystitis. […] Pain with bladder filling that reproduces the patients’ interstitial cystitis symptoms is very supportive of a diagnosis of interstitial cystitis.

• #33 Interstitial cystitis: Simplified diagnosis and treatment

  https://www.contemporaryobgyn.net/view/interstitial-cystitis-simplified-diagnosis-and-treatment

  The potassium sensitivity test (PST) was developed to aid in the diagnosis of IC. […] Although the PST can be useful, false-positive and false-negative results are possible, and the test can be uncomfortable and irritating for the patient. Thus, it is no longer recommended for routine diagnosis of IC. […] For patients with a PUF questionnaire score greater than 10 to 15, and a history, review of symptoms, and exam suggestive of IC, administering the ABC as a confirmatory test should be considered. […] Patients should be told to schedule a follow-up visit to confirm the diagnosis. […] In the absence of infection, temporary improvement in symptoms for several hours or days after administration of the ABC can be used to support the diagnosis and justify the initiation of therapy. […] Once IC is diagnosed, multimodal therapy can be initiated as outlined in the following section. […] Although cystoscopy with hydrodistention under general anesthesia is no longer required for the diagnosis of IC, it continues to have a role in treatment. […] The ABC or bladder instillation is a helpful tool for diagnosis as well as therapy.

• #34 Interstitial cystitis – Wikipedia

  https://en.wikipedia.org/wiki/Interstitial_cystitis

  Interstitial cystitis (IC), a type of bladder pain syndrome (BPS), is chronic pain in the bladder and pelvic floor of unknown cause. […] The diagnosis is usually based on the symptoms after ruling out other conditions. […] Typically the urine culture is negative. […] Ulceration or inflammation may be seen on cystoscopy. […] A diagnosis of IC/BPS is one of exclusion, as well as a review of clinical symptoms. […] The American Urological Association Guidelines recommend starting with a careful history of the person, physical examination and laboratory tests to assess and document symptoms of interstitial cystitis, as well as other potential disorders. […] The KCl test, also known as the potassium sensitivity test, is no longer recommended. […] For complicated cases, the use of hydrodistention with cystoscopy may be helpful.

• #35 Interstitial Cystitis/Bladder Pain Syndrome | IntechOpen

  https://www.intechopen.com/chapters/87191

  The Potassium sensitivity test (PST) informs about urothelial permeability and dysfunction. It is non-specific and may be positive in urinary tract infection and radiation cystitis. […] IC/BPS is a complex chronic condition. The affected patients have a poor quality of life. No test is available to diagnose IC/BPS. It is, therefore, a diagnosis of exclusion. An exception is IC/BPS with Hunner lesion, where cystoscopy is diagnostic. The diagnosis is delayed due to the diagnostic approach. Sometimes it may co-exist with other chronic pain syndromes, which masks the diagnosis.

• #36 Interstitial Cystitis & Bladder Pain Syndrome | GLOWM

  https://www.glowm.com/section-view/heading/Interstitial%20Cystitis%20&%20Bladder%20Pain%20Syndrome/item/725

  Potassium stress test (PST) can be used to assist in the diagnosis of BPS, by demonstrating the bladder as the origin of the patients symptoms. Infusion of 200 mEq of potassium chloride into the bladder provokes symptoms such as pain and urgency, in patients with BPS. […] Recent AUA guidelines in 2011 do not recommend PST. The AUA argues that only 60% of patients who meet the NIDDK criteria test positive, and therefore it is not specific for BPS. Nevertheless, one must remember that the NIDDK criteria can also exclude 60% of patients with BPS. The PST has a sensitivity and specificity of 80% and 97%, respectively. […] Anesthetizing the bladder may determine whether the bladder is the origin of pain by proving pain relief. Local anesthetics such as 2% lidocaine or commercially available cocktails are infused into the bladder. This test may be implemented in patients with a high clinical suspicion for BPS, despite having a negative PST, or in a patient where the clinical picture is unclear.

• #37 Interstitial cystitis – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/interstitial-cystitis/

  Interstitial cystitis is a diagnosis of exclusion made in patients with symptoms lasting 6 weeks and a negative urine culture. […] Diagnosis is clinical. […] Perform an initial assessment to evaluate for alternative diagnoses. […] Refer to urology or urogynecology for advanced studies (e.g., cystoscopy and/or urodynamic studies) if there is diagnostic uncertainty. […] Urinalysis with microscopy and urine culture: to rule out bacterial cystitis. […] Low voiding frequency and/or high volume suggest an alternative diagnosis. […] Cystoscopy is indicated for concern for Hunner lesions. […] If Hunner lesions are detected on cystoscopy, simultaneous treatment can be provided. […] There are no established urodynamic criteria for interstitial cystitis. […] Studies are indicated for refractory symptoms to evaluate for lower urinary tract obstruction.

• #38 Wrong Diagnosis | Interstitial Cystitis Association

  https://www.ichelp.org/understanding-ic/diagnosis/wrong-diagnosis/

  Diagnosing IC/BPS can be challenging. […] The IC/BPS diagnosis process requires healthcare providers to rule out other conditions prior to making the clinical judgment that you have IC/BPS. […] IC/BPS is often mistaken for a urinary tract infection (UTI) or bladder infection, which it is not. […] The diagnosis of IC/BPS and overactive bladder (OAB) are easy to confuse. […] IC/BPS in men may be mistaken for chronic prostatitis. […] You might confuse hemorrhagic cystitis with IC/BPS because the symptoms are similar. […] Controversy swirls around the idea that pudendal nerve problems might be mistaken for IC/BPS or maybe cause it. […] Much of the research about the causes of IC/BPS is striving to sort out the overlap of IC/BPS with other chronic conditions. […] Diagnosing Complicated IC/BPS Cases.

• #39 Interstitial Cystitis: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/interstitial-cystitis

  Interstitial cystitis (IC) is a complex condition that is identified by chronic inflammation of the bladder muscle layers, which produces the following symptoms: pelvic and abdominal pain and pressure, frequent urination, urgency (feeling like you need to urinate, even right after urinating), incontinence (accidental leakage of urine). […] There are no tests that make a definitive diagnosis of IC, so many cases of IC go undiagnosed. Because IC shares many of the same symptoms of other bladder disorders, your doctor needs to rule these out first. […] You’ll be diagnosed with IC once your doctor determines that your symptoms aren’t due to one of these disorders.

• #40 Interstitial Cystitis: Urgency and Frequency Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/1001/p1199.html

  Interstitial cystitis is diagnosed by cystoscopy and hydrodistention of the bladder. Glomerulations or Hunner’s ulcers found at cystoscopy are diagnostic. […] Interstitial cystitis is often underdiagnosed or improperly diagnosed. A presumptive diagnosis may be made by looking for appropriate clinical criteria. […] The most typical symptom of interstitial cystitis is pelvic pain. The pain is relieved by voiding small amounts of urine from the bladder, but soon recurs as the bladder fills. […] Conditions that must be excluded to diagnose interstitial cystitis include bacteriuria, Chlamydia trachomatis infection, prostatitis, herpes simplex virus infection, neoplasia, neuropathic bladder dysfunction and gynecologic diseases such as vaginitis, urethral diverticulum, vulvar vestibulitis and endometriosis.

• #41 Interstitial Cystitis/Bladder Pain Syndrome | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/132252

  IC/BPS should be considered in all patients originally diagnosed with overactive bladder who do not improve on standard therapy. […] Neither cystoscopy nor urodynamics is required to diagnose IC/BPS according to the AUA guidelines. […] Cystoscopy primarily rules out malignancy, strictures, Hunner ulcers, and bladder outlet obstruction. […] A Hunner ulcer is characteristic and diagnostic of classic IC. […] Patients with Hunner ulcers generally respond well to treatment. […] Patients with IC/BPS who have not responded to standard therapy might have chronic prostatitis/chronic pelvic pain syndrome, and consideration should be given to a change in therapy. […] The workup should include laboratory examinations and procedures to identify other disorders that can produce symptoms similar to IC/BPS.

• #42 Interstitial cystitis/painful bladder syndrome: the influence of modern diagnostic criteria on epidemiology and on Internet search activity by the public – Davis – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/6804/html

  Readily available dipstick urinalysis can exclude active urinary tract infection. […] The broadened diagnostic criteria and increased prevalence by inclusion of patients hitherto can be considered positive. […] As diagnostic criteria continue to broaden and become more inclusive it is likely that the prevalence of IC/PBS will continue to increase.

• #43 Interstitial Cystitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/2055505-overview

  Interstitial cystitis is a clinical syndrome characterized by daytime and nighttime urinary frequency, urgency, and pelvic pain. Interstitial cystitis has no clear etiology or pathophysiology, and diagnostic criteria for the syndrome remain undefined. […] The term interstitial cystitis has been called into question. The International Continence Society coined the term painful bladder syndrome (suprapubic pain with bladder filling associated with increased daytime and nighttime frequency, in the absence of proven urinary infection or other obvious pathology) and reserves the diagnosis of interstitial cystitis for patients with characteristic cystoscopic and histologic features of the condition. […] An international consensus panel was able to generally agree on the following definition of IC/BPS: unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder and associated with lower urinary tract symptoms of more than 6 weeks’ duration, in the absence of infection or other identifiable causes.

• #44 Diagnosis | Interstitial Cystitis Association

  https://www.ichelp.org/understanding-ic/diagnosis/

  There is no definitive test to identify IC/BPS, doctors must rule out other treatable conditions before considering a diagnosis of IC/BPS. […] Because IC/BPS symptoms are similar to those of other disorders of the bladder and there is no definitive test to identify IC/BPS, doctors must rule out other treatable conditions before considering a diagnosis of IC/BPS. […] The diagnosis of IC/BPS is based on the presence of pain related to the bladder, usually accompanied by frequency and urgency, absence of other diseases that could cause the symptoms. […] Once other conditions are excluded, patients with characteristic signs and symptoms generally are treated for presumed IC/BPS. […] In certain circumstances, some clinicians may choose to evaluate further, with cystoscopy with hydrodistention under general anesthesia, or with urodynamic studies, or lidocaine instillation.

• #45  Interstitial Cystitis Network  – How is Bladder Pain Syndrome & Interstitial Cystitis Diagnosed?

  https://www.ic-network.com/interstitial-cystitis-diagnosis/

  How is bladder pain syndrome / interstitial cystitis diagnosed? […] According to the 2022 American Urology Association Guidelines for IC/BPS, your physician should: […] Interstitial cystitis is the presumed diagnosis in patients who struggle with urinary symptoms (pain, frequency, urgency) for six weeks or longer and who have negative laboratory results for infection. […] The American Urology Association does NOT recommend additional invasive testing UNLESS the diagnosis is in doubt. […] If you have visible blood in your urine and/or the physician isn’t quite sure about your diagnosis, they may request some additional tests, including: […] A minor procedure performed in a doctors office, a simple cystoscopy allows the physician to look at the bladder to rule out other conditions that can mimic IC symptoms, such as bladder cancer or stones. […] If Hunner’s lesions are identified during the hydrodistention and cystoscopy, a diagnosis of IC is confirmed. […] Glomerulations are suggestive of, but not specific to, a diagnosis of IC because they can occur in other bladder conditions as well.

• #46 Interstitial Cystitis/Bladder Pain Syndrome | IntechOpen

  https://www.intechopen.com/chapters/87191

  Interstitial cystitis or bladder pain syndrome (IC/BPS) is a chronic debilitating condition of uncertain etiology. The American Urology Association (AUA) guidelines define IC/BPS as an unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms of more than 6 weeks duration in the absence of infection or other identifiable causes. […] IC/BPS is a diagnosis of exclusion. No definitive diagnostic test for IC/BPS exists apart from IC/BPS with Hunner lesion, diagnosed on cystoscopy. The diagnosis is delayed in most cases by 5-6 years. Detailed history taking, examination and laboratory investigations help reach the diagnosis. […] According to AUA 2022 guidelines, cystoscopy is not essential for diagnosing IC/BPS. However, cystoscopy is performed to exclude other differential diagnoses. IC/BPS with Hunner lesion is an exception where cystoscopy is diagnostic.

• #47 The Pathomechanism and Current Treatments for Chronic Interstitial Cystitis and Bladder Pain Syndrome

  https://www.mdpi.com/2227-9059/12/9/2051

  Patients with IC/BPS may have urgency symptoms but not urinary incontinence. […] Instead, this urgency is typically directed towards avoiding bladder pain. […] On cystoscopy, an erythematous patch with radiating vessels called a Hunner’s lesion is usually observed on the posterior wall. […] Patients with this feature are considered to have Hunner’s IC (HIC). […] Patients with IC/BPS symptoms but without a Hunner’s lesion typically present with characteristic glomerulation after cystoscopic hydrodistension under anesthesia and are thus diagnosed with non-Hunner’s IC (NHIC). […] Patients with NHIC often have multiple associated organ complaints, including gastroesophageal reflux disease, myofascial pain, insomnia, depression, and anxiety. […] HIC and NHIC are considered to be two distinct bladder disorders.

• #48 Interstitial Cystitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/2055505-overview

  Because no discrete pathognomonic pathologic criteria exist for assessing and monitoring disease severity, indications and goals for treatment are based on the degree of patient symptoms. […] Assessing patient response to treatment is also complicated because of the subjective nature of symptoms; the waxing and waning nature of symptoms without treatment; and the lack of objective serologic, physical, or histopathologic findings. […] Clinical presentation is also variable, with nonulcerative patients presenting with a more diffuse pain syndrome and multiple systemic complaints. […] As such, the ulcerative subtype responds better to bladder-targeted therapies, including cauterization and cystectomy.

• #49 Broaden Horizons: The Advancement of Interstitial Cystitis/Bladder Pain Syndrome

  https://www.mdpi.com/1422-0067/23/23/14594

  The clinical signs of IC/BPS patients are nonspecific; nevertheless, suprapubic tenderness and bladder neck point tenderness are prevalent in both sexes. […] Laboratory tests mainly include urinalysis and urine culture, and AUA, JUA, CUA, EAU, RCOG, and ICI-RS recommend these tests to exclude other diseases, such as bacterial cystitis, tuberculous cystitis, and vaginitis. […] JUA, RCOG, CUA, EAU, BJOG, and ICI-RS recommend cystoscopy as part of the initial evaluation to rule out other diseases. […] Cystoscopy can not only assist diagnosis but also can differentiate HIC from NHIC, which is helpful for the treatment, considering their different responses to therapy. […] Collectively, IC/BPS is a diagnosis of exclusion, and other known medical diseases must be ruled out before a diagnosis of IC/BPS is confirmed.

• #50 Interstitial Cystitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/2055505-overview

  Despite years of intensive research, there are no specific clinical or urinary markers currently clinically available; no absolutely specific radiographic, laboratory, or serologic findings; and no biopsy patterns that are pathognomonic for IC/BPS. The syndrome remains a diagnosis of exclusion. […] Intensive study has been done to attempt to identify biomarkers for IC/BPS. Some interesting studies have shown that bladder nitric oxide is an accurate marker for Hunner lesions, but these are not present in all patients, and the test requires specific equipment, which has limited its widespread clinical use. […] Perhaps the most promising urinary biomarker for IC/BPS is antiproliferative factor (APF). […] Studies have also suggested a role for APF in the therapeutic effect of hydrodistension in patients with IC/BPS, although further confirmatory studies are necessary.

• #51 Interstitial Cystitis/Bladder Pain Syndrome | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/132252

  A number of urinary inflammatory biomarkers are increased in IC/BPS, such as TNF-, PGE2, IL-2, IL-6, IL-8, IP10, TAC, and 8-OHdG, although the diagnostic and clinical utility of this finding still needs to be determined. […] The chronic inflammatory bladder changes and negative bacterial cultures associated with IC/BPS could be explained by a viral infection such as Epstein-Barr virus (EBV), found in up to 87.5% of patients.

• #52 Interstitial Cystitis Workup: Approach Considerations, Cystoscopy, Bladder Biopsy

  https://emedicine.medscape.com/article/2055505-workup

  Urethral and vaginal culture results should be obtained for pathologic organisms (eg, fungi and gonorrheal, chlamydial, and trichomonal species). […] Various assays for stress protein genes, glycosaminoglycans, mast cell tryptase, Tamm-Horsfall protein autoantibodies, and others have been suggested by numerous investigators. […] In men, expressed prostatic secretions yield no findings specific for interstitial cystitis. […] Ke et al propose that the serum neutrophil-to-lymphocyte ratio (NLR) holds promise as a biomarker for diagnosis and symptom evaluation in patients with interstitial cystitis/bladder pain syndrome. […] Cystoscopy is described as the most important diagnostic tool for assessing a patient who may have interstitial cystitis. […] Cystoscopy, with bladder overdistention, is performed to help exclude other causes of symptoms suggestive of interstitial cystitis and to provide evidence for the diagnosis of interstitial cystitis.

• #53 Interstitial cystitis (bladder pain syndrome) – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/297

  Interstitial cystitis (bladder pain syndrome) is a chronic, often debilitating clinical syndrome of urinary frequency, urgency, and pelvic pain. Symptoms vary with bladder filling. […] Diagnosis is one of exclusion, and physicians must carefully consider all patients with chronic pelvic pain as potential candidates. […] IC/BPS is a diagnosis of exclusion, so other common disease processes must first be excluded before effective treatment can be initiated. […] Diagnostic tests include urinalysis with microscopy and culture, vaginal wet prep, voiding diary, and urine cytology. […] Tests to consider include cystoscopy with hydrodistention of bladder and bladder biopsy. […] Emerging tests include stress protein gene assay, urine antiproliferative factor, and urine nerve growth factor (NGF).

• #54

  https://journals.lww.com/ursc/fulltext/2021/32010/toward_a_validated_diagnostic_test_with_machine.2.aspx

  Diagnosing interstitial cystitis/bladder pain syndrome (IC/BPS) is difficult as there is no definitive test for IC/BPS. Instead, the diagnosis is based on urinary symptoms and cystoscopy may be recommended. However, cystoscopic diagnosis is associated with potentially exacerbating painful side effects and is highly subjective among physicians. […] IC/BPS is currently diagnosed by urinary symptoms and pain levels, as well as physical examination. There is currently no commercial biomarker test available. […] The diagnostic tool we are developing is the IC-risk score (IC-RS), which may aid clinicians and researchers in classifying IC/BPS patients, track disease progression, and possibly determine response to therapy. […] Our current research aims to build a new ML RS to distinguish all IC/BPS participants (both NHIC and HIC) from controls, the IC-RS.

• #55

  https://journals.lww.com/ursc/fulltext/2021/32010/toward_a_validated_diagnostic_test_with_machine.2.aspx

  The IC-RS ML classifier was trained using data obtained in our previous urine collection. This RFC binary classifier will categorize subjects as either having or not having IC/BPS based on the levels of measured cytokines and OPSI score. […] The result of this research is hopefully a diagnostic product that will be the first regulatory approved clinical laboratory test for IC/BPS.

• #56 The Evaluation and Management of Interstitial Cystitis/Bladder Pain Syndrome – European Medical Journal

  https://www.emjreviews.com/urology/article/the-evaluation-and-management-of-interstitial-cystitis-bladder-pain-syndrome/

  The authors always perform a biopsy of a HL to rule out carcinoma in situ and then use a roller ball on a resectoscope and rapidly fulgurate over the lesions to avoid a deep burn. […] The authors routinely prescribe cyclosporine for patients with recurrent HL at a starting dose of 100 mg twice daily for 30 days followed by 100 mg once daily. […] When all other therapies have failed, substitution cystoplasty or urinary diversion with or without cystectomy is an option according to the AUA guidelines. […] An IC/BPS specialist should evaluate patients prior to considering surgery. […] No clear pathophysiologic explanation of IC/BPS has been determined, but some proposed mechanisms focus on the dysfunction of the bladder epithelium, extracellular matrix, and associated immune mediators. […] A multidisciplinary approach is crucial for success in treating N-HLIC/BPS. […] It is critical to carefully phenotype these patients, identify pain triggers, and direct therapy towards these triggers.

• #57 Interstitial Cystitis/Bladder Pain Syndrome: Diagnosis and Subtypes

  https://pelvicpainrehab.com/blog/interstitial-cystitis-bladder-pain-syndrome-diagnosis-and-subtypes/

  Interstitial Cystitis/Bladder Pain Syndrome is defined as an unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms of more than six weeks duration, in the absence of infection or other identifiable causes. […] Most people diagnosed with Interstitial Cystitis/Bladder Pain Syndrome are diagnosed based on symptoms alone without a proper workup from a provider to find the root cause, aside from possibly ruling out an infection. […] The AUA updated their guidelines in 2022 defining the diagnosis as primarily a neuromuscular disorder rather than a bladder disease. […] A thorough workup is still needed to best understand the factors contributing to symptoms in each individual case. […] Identifying the underlying causes whether its pelvic floor dysfunction, hormonal imbalances, or a combination of factors allows for tailored therapeutic approaches.

• #58 Interstitial Cystitis(IC)/Bladder Pain Syndrome | University of Michigan Health

  https://www.uofmhealth.org/conditions-treatments/adult-urology/interstitial-cystitisic-bladder-pain-syndrome

  Your health care provider may run other tests to rule out health issues that may seem like IC/BPS. […] At this time, there is no clear answer about the best way to diagnose IC/BPS. However, if a patient has typical symptoms and a negative urine exam showing no infection or blood, then IC/BPS should be suspected.

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