Interstitial Cystitis/Bladder Pain Syndrome



Interstitial cystitis or bladder pain syndrome is a chronic condition of suprapubic pain associated with bladder distention and accompanied by lower urinary tract symptoms such as urgency, frequency, and nocturia. Commonly affecting those in the fourth and fifth decades with a strong preponderance for female gender, IC has a complex and poorly understood pathophysiology which involves urothelial dysfunction, inflammatory disturbances, neuroendocrine changes, and central sensitization. The mainstays of treatment include patient education, diet and activity modification, and physical therapy as well as both oral and intravesicular therapies. Common oral pharmacologic agents include amitriptyline, hydroxyzine, cimetidine, pentosan polysulfate, and cyclosporine, while common intravesicular therapies include heparin, lidocaine, hyaluronic acid, chondroitin sulfate, pentosan polysulfate, dimethyl sulfoxide, triamcinolone, and botulinum toxin A. For patients not responsive to more-conservative therapies, a host of interventions and surgeries can be done including cystoscopy and fulguration of ulcerative lesions, neuromodulation, and cystectomy. Current research involves discovery of biomarkers to aid in diagnosis of IC as well as development of both oral and intravesicular therapies aimed at providing greater relief to those suffering from BPS.


Interstitial cystitis Bladder pain syndrome Urinary tract Intravesicular Hunner’s lesions 


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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Anesthesiology and Pain MedicineUC Davis Medical CenterSacramentoUSA
  2. 2.Department of Anesthesia and Critical CareUniversity of ChicagoChicagoUSA

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