Bladder Pain Syndrome Associated with Interstitial Cystitis: Recent Research and Treatment Options

This article reports recently published research in diagnosis and treatment of IC/BPS.Recent FindingsCurrent research shows that the syndrome is likely heterogeneous, with different pathogeneses, clinical characteristics, cystoscopic findings, and characteristics of urine biomarkers. Chronic bladder inflammation results in deficits in the bladder urothelial barrier in addition to increased apoptosis and impaired regeneration of urothelial cells, causing bladder pain symptoms and urinary frequency and urgency. The initial therapeutic approach is conservative treatment with lifestyle modification, anti-inflammatory drugs, and intravesical glycosaminoglycan replenishment and dimethyl sulfoxide instillation. In patients with non-Hunner ’s lesion IC/BPS refractory to conventional therapy, intravesical botulinum toxin A injection and sacral neuromodulation may be tried. Experimental therapies are intravesical platelet-rich plasma, low-energy shock wave bladder treatment and bladder instillation of liposomes with or without mixed b otulinum toxin A. For IC/BPS patients with Hunner’s lesion, electrocauterization or laser ablation is the first-line treatment. Patients with Epstein-Barr virus infection may also benefit from antiviral therapy. For patients with Hunner’s IC/BPS and a contracted bladder, partial cystectomy with augmentation enterocystoplasty or total cystectomy with urinary diversion should be the last resort for treatment to address early elimination and bladder pa...
Source: Current Bladder Dysfunction Reports - Category: Urology & Nephrology Source Type: research