A standard for terminology in chronic pelvic pain syndromes: A report from the chronic pelvic pain working group of the international continence society

Doggweiler, Ragi; Whitmore, Kristene; Meijlink, Jane; Drake, Marcus; Frawley, Helena; Nordling, Jørgen; Hanno, Philip; Fraser, Matthew O.; Homma, Yukio; Garrido, Gustavo; Gomes, Mario; Elneil, Sohier; Merwe, J. P. van de; Lin, Alex Tong‐Long; Tomoe, Hikaru

doi:10.1002/nau.23072

Cited by 170 publications

(185 citation statements)

References 127 publications

(271 reference statements)

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“…Guidelines from the British Pain Society were not included in the present review as, although they offer general guidance on pelvic pain, they do not focus specifically on bladder pain syndrome. The following guidelines were included in the review: EAU , AUA , ESSIC , International Consultation on Incontinence (ICI) , ICS , East Asian guideline , Royal College of Obstetricians and Gynaecologists/BSUG and the CUA .…”

Section: Methodsologymentioning

confidence: 99%

“…Throughout the literature, a range of terms are used interchangeably to describe this condition, including BPS, painful bladder syndrome (PBS), interstitial cystitis (IC), and combinations of these terms (IC/PBS, IC/BPS, BPS/IC and IC/BPS) . A working group from the ICS has recently attempted to standardize the terminology in chronic pelvic pain syndromes, and has distinguished between hypersensitive bladder, IC/BPS, and IC with Hunner lesion . It is now thought, however, that IC with Hunner lesion represents a different disease process, requiring different management strategies, and there is debate about whether this should now be completely separated from BPS.…”

Section: Introductionmentioning

confidence: 99%

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Guideline of guidelines: bladder pain syndrome

et al. 2018

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There is disagreement between guidelines on the exact definition of BPS and the nomenclature to use to describe this condition. However, all agree that the diagnosis is dependent on the presence of pain, pressure, or discomfort, in addition to at least one urinary symptom, in the absence of other diseases that could cause pain. Exclusion of other pathology that could cause similar symptoms requires thorough evaluation, and is recommended in all guidelines. There is also disparity in the recommended diagnostic investigation of BPS, with hydrodistension and bladder biopsy either recommended, considered optional, or not recommended, by different guidelines. It is accepted that BPS can be diagnosed clinically, without invasive investigation, but cystoscopy and diagnostic hydrodistension aids sub-typing of patients and may help direct treatment strategies. Patients should be phenotyped in order to direct multimodal treatment (including behavioural, physical, emotional, and psychological therapy), and treatments should follow a stepwise approach starting with the most conservative. Although widely performed, hydrodistension as a therapeutic strategy has a limited evidence base and is unlikely to provide long-term resolution of symptoms CONCLUSION: There are multiple national and international guidelines for the diagnosis and management of BPS, and this review has highlighted the differences in nomenclature, definitions, and recommended diagnostic tests between guidelines. The overall evidence base for the majority of treatments for BPS/IC is of low-quality, and larger randomised trials are required to more accurately inform guideline recommendations and clinical management of this complex group of patients.

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Section: Methodsologymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Guideline of guidelines: bladder pain syndrome

et al. 2018

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“…Other urological, gynecological, gastrointestinal and colorectal pain conditions without related PFM dysfunction, are well described in standard texts. Many pelvic floor pain‐related conditions or syndromes (e.g., vulvodynia, interstitial cystitis/bladder pain syndrome, irritable bowel syndrome) are described in the Standard for Terminology in Chronic Pelvic Pain Syndromes (CPPS): A Report from the Ad Hoc Working Group of the International Continence Society Standardization Steering Committee (ICS‐SSC) on Chronic Pelvic Pain, ICS Standardization of Terminology document on Chronic Pelvic Pain . Several other systemic disorders (e.g., chronic fatigue syndrome, diabetes) may have an impact on the pelvic floor; however, PFD is not part of their recognized etiology.…”

mentioning

confidence: 99%

An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction

Bø

Frawley

Haylen

et al. 2016

Neurourology and Urodynamics

299

310

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Introduction and hypothesis There has been an increasing need for the terminology on the conservative management of female pelvic floor dysfunction to be collated in a clinically based consensus report. Methods This Report combines the input of members and elected nominees of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS), assisted at intervals by many external referees. An extensive process of nine rounds of internal and external review was developed to exhaustively examine each definition, with decision-making by collective opinion (consensus). Before opening up for comments on the webpages of ICS and IUGA, five experts from physiotherapy, neurology, urology, urogynecology, and nursing were invited to comment on the paper. Results A Terminology Report on the conservative management of female pelvic floor dysfunction, encompassing over 200 separate definitions, has been developed. It is clinically based, with the most common symptoms, signs, assessments, diagnoses, and treatments defined. Clarity and ease of use have been key aims to make it interpretable by practitioners and trainees in all the different specialty groups involved in female pelvic floor dysfunction. Ongoing review is not only anticipated, but will be required to keep the document updated and as widely acceptable as possible. Conclusion A consensus-based terminology report for the conservative management of female pelvic floor dysfunction has been produced, aimed at being a significant aid to clinical practice and a stimulus for research.

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“…Thus, according to the organization defining the syndrome, both the syndrome's name and the diagnosis can vary. Pain is considered a key feature of BPS by the EAU, AUA, ICI, CUA, ICS, RCOG, and ESSIC; however, urinary frequency and urgency are the predominant complaints (along with pressure or discomfort) in the East Asian guideline definition of BPS . This may suggest a geographic difference in clinical presentation.…”

Section: Introductionmentioning

confidence: 99%

How can we improve the diagnosis and management of bladder pain syndrome? Part 1: ICI‐RS 2018

Khullar

Chermansky

Tarcan

et al. 2019

Neurourology and Urodynamics

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Background: This paper summarizes the discussion in a think tank at the ICI-RS 2018 about the diagnosis of bladder pain syndrome (BPS). Aims: To review the guidelines, investigations and subtypes of BPS. Materials and Methods: Review of literature in the light of the think tank discussion.Results: All guidelines recommend completing history, physical examination, urine analysis, urine culture, and urine cytology to define the BPS phenotype but there are differences on further investigations. In those guidelines which recommend cystoscopy, the identification of Hunner's lesions (HLs) is recommended as this changes the treatment plan and outcome. Conclusion: We propose that the differentiation of Hunner's ulcers is an important step in the assessment of these patients. Further suggestions for research are suggested.

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A standard for terminology in chronic pelvic pain syndromes: A report from the chronic pelvic pain working group of the international continence society

Cited by 170 publications

References 127 publications

Guideline of guidelines: bladder pain syndrome

Guideline of guidelines: bladder pain syndrome

An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction

How can we improve the diagnosis and management of bladder pain syndrome? Part 1: ICI‐RS 2018

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