Interstitial cystitis/bladder pain syndrome (IC/BPS) is a complex chronic condition requiring a multimodal and individualized management approach. This article presents current treatment recommendations for IC/BPS, covering the full therapeutic spectrum from lifestyle and dietary measures to last-resort surgical options. Behavioral interventions, patient education, pelvic floor physical therapy, and psychological support form the cornerstone of first-line management. When these measures prove insufficient, pharmacological treatments - including conventional and atypical analgesics, as well as systemic oral therapies such as pentosan polysulfate sodium - along with intravesical instillations of glycosaminoglycans or dimethyl sulfoxide, may be considered. Interventional techniques, including hydrodistension, intravesical injections of onabotulinumtoxinA, and sacral neuromodulation, represent effective options for refractory patients. Excisional surgery and urinary diversion remain reserved for a carefully selected subgroup of patients presenting with severe, documented bladder-centric disease. Rigorous phenotypic patient selection is the cornerstone of all therapeutic decisions and the principal determinant of prognosis.
The French journal of urology. 2026 Jul 23 [Epub ahead of print]
F Meyer, C A Brandon, C Saussine, S Borojeni, P-O Bosset, S Campagne-Loiseau, J-N Cornu, L Donon, L Even, M Florin, F Hervé, J Klap, M A Perrouin Verbe, C Plassais, C Richard, A Vidart, S Lebdai, A Levesque, C Thuillier, B Peyronnet
Department of Urology, Hôpital Saint-Louis, AP-HP, Paris, France; Department of Urology, Hôpital Privé des Peupliers, groupe Ramsay, Paris, France. Electronic address: ., Department of Gynecology, Hôpital Paris-Saclay, Orsay, France., Department of Urology, Nouvel Hôpital Civil, 1, place de l'Hôpital, BP 426, 67091 Strasbourg, France., Department of Urology Clinique Saint Jean de Dieu, 2 rue Rousselet, Paris, 75007 France., Department of Urology, Hôpital Foch, Suresnes, France., Department of Gynecology, CHU of Estaing, University of Clermont-Ferrand, Clermont-Ferrand, France., Department of Urology, CHU de Rouen, Rouen, France., Department of Urology, Clinique Belharra, groupe Ramsay, Bayonne, France., Department of Urology, Hôpital Privé Les Fleurs, Ollioules, France., Department of Radiology, Hôpital Tenon, AP-HP, Paris, France; Department of Radiology, Hôpital Privé des Peupliers, groupe Ramsay, Paris, France., Department of Urology, Ghent University Hospital, Ghent, Belgium., Department of Urology, Hôpital Privé Claude-Galien, groupe Ramsay, Quincy-sous-Sénart, France., Department of Urology, Centre Hospitalier Universitaire de Nantes, Nantes, France., Department of Urology, University of Rennes, Rennes, France., Department of Urology, CHU Angers, Angers, France - in the name of the CTMH (Committee on Male Lower Urinary Tract Symptoms), France., Pain Management Centre, CHU Nantes, Bd Jacques Monod, 44093 Nantes, UMR INSERM 1229, France., Department of Urology, CHU Grenoble-Alpes, La Tronche, France., Department of Urology, CHU de Rennes, Rennes, France.