Interstitial Cystitis / Bladder Pain Syndrome (IC/BPS)
The primary chronic bladder condition in women, characterized by bladder pain, urgency, and frequency without identifiable infection or other obvious pathology.
Overview
Interstitial Cystitis / Bladder Pain Syndrome (IC/BPS) is a chronic condition characterised by bladder pain or pressure with urgency and frequency, in the absence of identifiable infection or other pathology. Nine in ten patients are women, and the average woman sees five physicians over seven years before receiving a correct diagnosis.
Key Symptoms
- Suprapubic pain worsening with bladder filling
- Urinary urgency and frequency (>8/day)
- Nocturia — waking multiple times per night
- Pelvic pressure and heaviness
- Dyspareunia (pain during intercourse)
Pathophysiology
Urothelial GAG layer deficiency allows urinary irritants to penetrate the bladder wall, triggering mast cell activation, neurogenic inflammation, and eventually central sensitization.
Treatment Approach
Conservative lifestyle measures, oral Pentosan Polysulfate Sodium (Elmiron®), intravesical instillations, and escalation to neuromodulation or surgery in refractory cases.