Interstitial cystitis (bladder pain syndrome)

American Urological Association (AUA) Guideline 2022: diagnostic criteria for IC/BPS[1]Clemens JQ, Erickson DR, Varela NP et al. Diagnosis and treatment of interstitial cystitis/bladder pain syndrome: AUA guideline amendment. J Urol. 2022 July;208(1):34-42. https://www.auajournals.org/doi/10.1097/JU.0000000000002756 ​​

• An unpleasant sensation of pain, pressure and/or discomfort in the pelvic area perceived to be related to the urinary bladder (patients typically report pain throughout the pelvis, including suprapubic, urethra, vulva, vagina, rectum, lower abdomen, and back pain)

• Absence of infection or other identifiable causes

• Duration of more than 6 weeks.

Canadian Urological Association (CUA) guideline 2016: diagnostic criteria for IC/BPS[40]Cox A, Golda N, Nadeau G, et al. CUA guideline: diagnosis and treatment of interstitial cystitis/bladder pain syndrome. Can Urol Assoc J. 2016 May-Jun;10(5-6):E136-55. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5065402 http://www.ncbi.nlm.nih.gov/pubmed/27790294?tool=bestpractice.com

• History describing a combination of pain, frequency, nocturia, and urgency

• Physical examination revealing suprapubic and bladder neck point tenderness and without masses, bladder distention, hernias, levator myalgia, or evidence of vaginal pathology, such as cervical cancer, vaginismus, or vulvodynia

• Frequency-volume chart showing small frequent voided volumes

• Urinalysis, urine culture to rule out infection; consider atypical organisms with sterile pyuria

• Urine cytology with microscopic hematuria or risk factors for urothelial cancer

• Symptom scores to determine baseline symptom severity and response to treatments: these include Interstitial Cystitis Symptom Index (ICSI), Interstitial Cystitis Problem Index (ICPI), Wisconsin Interstitial Cystitis scale (UW-IC scale), the Pain, Urgency, Frequency score (PUF score), and the Bladder Pain / IC Symptom Score (BPIC-SS)

• Cystoscopy to evaluate for Hunner’s ulcers, to rule out bladder cancer or carcinoma in situ, to evaluate effect of bladder filling on pain, and to estimate functional bladder capacity.