Urological presentations are common in general practice. Many are straightforward presentations such as lower urinary tract infections. Nevertheless, GPs must always consider more serious causes, not least renal disease and cancer. A further challenge lies in unexplained, persistent or treatment-resistant symptoms, which may be associated with chronic pain. A key urological presentation that captures all of these is interstitial cystitis/bladder pain syndrome. This diagnosis of exclusion calls for thorough history taking, appropriate investigation, strategies to exclude sinister causes and management options for chronic symptoms.
Get full access to this article
View all access options for this article.
References
1.
BerrySElliottMSuttorpM, et al. (2011)
Prevalence of symptoms of bladder pain syndrome/interstitial cystitis among adult females in the United States.The Journal of Urology86(2), 540–544. DOI: 10.1016/j.juro.2011.03.132.
2.
BirderL (2019)
Pathophysiology of interstitial cystitis. International Journal of Urology26: 12–15. DOI: 10.1111/iju.13985.
3.
ClemensJ (2021) Interstitial cystitis/bladder pain syndrome: Clinical features and diagnosis. In: UpToDate, Topic 8074 (V40.0), UpToDate, Waltham, MA.
4.
ColemeadowJSahaiAMaldeS (2020)
Clinical management of bladder pain syndrome/interstitial cystitis: A review on current recommendations and emerging treatment options. Research and Reports in Urology18(12); 331–343. DOI: 10.2147/RRU.S238746.
5.
CraneALloydJShoskesD (2018)
Improving the utility of clinical phenotyping in interstitial cystitis/painful bladder syndrome: From UPOINT to INPUT. The Canadian Journal of Urology25(2): 9250–9254.
6.
HakimiZHoubiersJPedersiniR, et al. (2017)
The burden of bladder pain in five European countries: A cross-sectional study. Urology1(99): 84–91. DOI: 10.1016/j.urology.2016.08.038.
7.
HommaYAkiyamaYTomoeH, et al. (2020)
Clinical guidelines for interstitial cystitis/bladder pain syndrome. International Journal of Urology27(7): 578–589. DOI: 10.1111/iju.14234.
8.
LubeckDWhitmoreKSantG, et al. (2001)
Psychometric validation of the O’Leary-Sant interstitial cystitis symptom index in a clinical trial of pentosan polysulfate sodium. Urology57(6) 62–66. DOI: 10.1016/S0090-4295(01)01126-8.
9.
ParsonsC (2007)
The role of the urinary epithelium in the pathogenesis of interstitial cystitis/prostatitis/urethritis. Urology69(4): S9–S16. DOI: 10.1016/j.urology.2006.03.084.
SuskindABerrySEwingB, et al. (2013)
The prevalence and overlap of interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome in men: Results of the RAND Interstitial Cystitis Epidemiology male study. TheJournal of Urology189(1): 141–145. DOI: 10.1016/j.juro.2012.08.088.
TirlapurSCarberryCKhanK, et al. (2016)
Management of bladder pain syndrome (Green-top Guideline No. 70). British Journal of Obstetrics and Gynaecology124: e46–e72. DOI: 10.1111/1471-0528.14310.
14.
Van de MerweJNordlingJBoucheloucheP, et al. (2008)
Diagnostic criteria, classification, and nomenclature for painful bladder syndrome/interstitial cystitis: An ESSIC proposal. European Urology53(1): 60–67. DOI: 10.1016/j.eururo.2007.09.019.
