Current standard of care in treatment of bladder pain syndrome/interstitial cystitis

Bladder pain syndrome/interstitial cystitis (BPS/IC) is a debilitating, systemic pain syndrome with a cardinal symptom of bladder related pain with associated systemic symptoms. It is characterized by an inflammation that partially or completely destroys the mucus membrane and can extend into the mu...

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Main Authors: Sabela Rodriguez Lopez, Naşide Mangır
Format: Article
Language:English
Published: SAGE Publishing 2021-06-01
Series:Therapeutic Advances in Urology
Online Access:https://doi.org/10.1177/17562872211022478
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author Sabela Rodriguez Lopez
Naşide Mangır
author_facet Sabela Rodriguez Lopez
Naşide Mangır
author_sort Sabela Rodriguez Lopez
collection DOAJ
description Bladder pain syndrome/interstitial cystitis (BPS/IC) is a debilitating, systemic pain syndrome with a cardinal symptom of bladder related pain with associated systemic symptoms. It is characterized by an inflammation that partially or completely destroys the mucus membrane and can extend into the muscle layer; however, the etiology and pathogenesis is still enigmatic. It has been suggested that mast cell activation, defects in the glycosaminoglycan layer, non-functional proliferation of bladder epithelial cells, neurogenic inflammation, microvascular abnormalities in the submucosal layer, autoimmunity and infectious causes may cause BPS/IC. Available treatment options include general relaxation techniques, patient education, behavioral treatments, physical therapy, multimodal pain therapy, oral (amitriptyline, cimetidine, hydroxyzine) and intravesical treatments (heparin, lidocaine, hyaluronic acid and chondroitin sulfate), hydrodistension and other more invasive treatments. Available treatments are mostly not based on a high level of evidence. Lack of understanding of disease mechanisms has resulted in lack of targeted therapies on this area and a wealth of empirical approaches with usually inadequate efficacy. The aim of this article is to review the available evidence on the pathophysiological mechanisms of BPS/IC as they relate to available treatment options.
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spelling doaj.art-af90c2a65852436dab9cb3cc532363b62022-12-21T19:22:57ZengSAGE PublishingTherapeutic Advances in Urology1756-28802021-06-011310.1177/17562872211022478Current standard of care in treatment of bladder pain syndrome/interstitial cystitisSabela Rodriguez LopezNaşide MangırBladder pain syndrome/interstitial cystitis (BPS/IC) is a debilitating, systemic pain syndrome with a cardinal symptom of bladder related pain with associated systemic symptoms. It is characterized by an inflammation that partially or completely destroys the mucus membrane and can extend into the muscle layer; however, the etiology and pathogenesis is still enigmatic. It has been suggested that mast cell activation, defects in the glycosaminoglycan layer, non-functional proliferation of bladder epithelial cells, neurogenic inflammation, microvascular abnormalities in the submucosal layer, autoimmunity and infectious causes may cause BPS/IC. Available treatment options include general relaxation techniques, patient education, behavioral treatments, physical therapy, multimodal pain therapy, oral (amitriptyline, cimetidine, hydroxyzine) and intravesical treatments (heparin, lidocaine, hyaluronic acid and chondroitin sulfate), hydrodistension and other more invasive treatments. Available treatments are mostly not based on a high level of evidence. Lack of understanding of disease mechanisms has resulted in lack of targeted therapies on this area and a wealth of empirical approaches with usually inadequate efficacy. The aim of this article is to review the available evidence on the pathophysiological mechanisms of BPS/IC as they relate to available treatment options.https://doi.org/10.1177/17562872211022478
spellingShingle Sabela Rodriguez Lopez
Naşide Mangır
Current standard of care in treatment of bladder pain syndrome/interstitial cystitis
Therapeutic Advances in Urology
title Current standard of care in treatment of bladder pain syndrome/interstitial cystitis
title_full Current standard of care in treatment of bladder pain syndrome/interstitial cystitis
title_fullStr Current standard of care in treatment of bladder pain syndrome/interstitial cystitis
title_full_unstemmed Current standard of care in treatment of bladder pain syndrome/interstitial cystitis
title_short Current standard of care in treatment of bladder pain syndrome/interstitial cystitis
title_sort current standard of care in treatment of bladder pain syndrome interstitial cystitis
url https://doi.org/10.1177/17562872211022478
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