Summary of the 2023 report of the international consultation on incontinence interstitial cystitis/bladder pain syndrome (IC/BPS) committee

Hanno, Philip; Cervigni, Mauro; Choo, Myung Soo; Clemens, J. Quentin; Lee, Ming-Huei; Malde, Sachin; Meijlink, Jane; Samarinas, Michael; Ueda, Tomohiro; Gold, Daniela

doi:10.1016/j.cont.2023.101056

Cited by 8 publications

(1 citation statement)

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“…Although IC has been assumed to be a bladder disorder for centuries ( 109 , 110 ), recent literature reviews of cystoscopy studies reported finding no convincing evidence that glomerulations (punctate petechial hemorrhages observed after hydrodistension) should be included in the diagnosis or phenotyping of IC since they did not correlate with symptoms and were found in patients without IC ( 111 ). Based on these results, the 2023 report of a committee of the International Continence Society concluded that “clinically at this time, the presence or absence of glomerulations on cystoscopy should not be used as a diagnostic or prognostic criterion for IC….” ( 112 ). Another recent study also cast doubt on the usefulness of bladder biopsy for the evaluation of severity in women with non-Hunner lesion IC ( 113 ).…”

Section: Introductionmentioning

confidence: 99%

Interstitial cystitis—an imbalance of risk and protective factors?

Westropp,

Stella,

Buffington

2024

Front. Pain Res.

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Interstitial cystitis (IC) presents as a chronic pain condition with variable combinations of symptoms depending on the species and individual patient. It is diagnosed by the presence of lower urinary tract signs and symptoms in combination with a variety of comorbid health problems, a history of life adversities, and the absence of other conditions that could cause the lower urinary tract signs. IC occurs naturally in humans and cats as a dimensional condition, with patients presenting with mild, moderate, and severe symptoms. Most patients appear to recover without specific treatment. A number of rodent models of IC have been used to study its causes and treatments. Unfortunately, current therapies generally fail to ameliorate IC symptoms long-term. The recent classification of IC as a chronic primary pain disorder calls for a rethinking of current clinical and research approaches to it. Beginning when a patient encounters a clinician, precipitating, perpetuating, and palliating risk factors can be addressed until a cause or reliably effective therapy is identified, and identifying predisposing and preventive factors can inform epidemiological studies and health promotion interventions. Predisposing, precipitating, and perpetuating risk factors, including environmental, psychological, and biological, increase the activity of the central threat response system (CTRS), which plays a clinically important role in IC symptoms. Studies in cats and rodent models have revealed that environmental enrichment (EE), in the absence of bladder-directed therapies, leads to amelioration of IC symptoms, implying a central role for the CTRS in symptom precipitation and perpetuation. Conceptually moving the source of IC pain to the brain as a motivational state rather than one resulting from peripheral nociceptive input offers both clinicians and researchers novel opportunities to improve care for patients with IC and for researchers to use more ecologically valid rodent models. It may even be that IC results from an excess of risk to protective factors, making this imbalance a targetable cause rather than a consequence of IC.

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Section: Introductionmentioning

confidence: 99%

Interstitial cystitis—an imbalance of risk and protective factors?

Westropp,

Stella,

Buffington

2024

Front. Pain Res.

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Coping With Interstitial Cystitis/Bladder Pain Syndrome

Sutherland,

Grace Kelly,

McKernan

et al. 2024

Neurourology and Urodynamics

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AimsCompensatory coping, or maladaptive alterations in behavior with the intention of preventing or managing symptoms, is increasingly being explored as a key factor in how people respond to bladder conditions. Preliminary investigations have identified relations between coping behaviors and psychological distress in urologic conditions, including interstitial cystitis/bladder pain syndrome (IC/BPS). However, previous explorations of coping have not accounted for heterogeneity in coping behaviors or addressed the likelihood that some coping behaviors may be more adaptive than others. This study sought to examine how two specific types of coping behaviors, primary control coping and disengaged coping, are related to distress and symptoms in IC/BPS, and to explore the potential role of pain phenotype in this relationship.Materials and MethodsA secondary data analysis was conducted with a large community data set (N = 677 women with IC/BPS) and employed descriptive and inferential statistics to characterize coping patterns and explore novel predictors of distress.ResultsResults indicated that almost all participants engaged in at least one compensatory coping behavior within the last week. Both types of coping behaviors correlated with psychological symptoms, and when controlling for relevant clinical variables (i.e., age and severity of urinary symptoms), disengaged coping behaviors were significantly associated with psychological distress. Further, the addition of pain phenotype to multiple regression models resulted in a more effective predictive model when considering the relation between coping behaviors and depression.ConclusionsBy investigating more deeply the relationship between coping and distress, understanding of potential risk factors and mechanisms is increased, offering valuable insights for intervention strategies for IC/BPS patients.

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