Clinical guidelines for interstitial cystitis and hypersensitive bladder updated in 2015

Clinical guidelines for interstitial cystitis and hypersensitive bladder have been updated as of 2015. The guidelines define interstitial cystitis by the presence of hypersensitive bladder symptoms (discomfort, pressure or pain in the bladder usually associated with urinary frequency and nocturia) and bladder pathology, after excluding other diseases explaining symptoms. Interstitial cystitis is further classified by bladder pathology; either Hunner type interstitial cystitis with Hunner lesions or non-Hunner type interstitial cystitis with mucosal bleeding after distension in the absence of Hunner lesions. Hypersensitive bladder refers to a condition, where hypersensitive bladder symptoms are present, but bladder pathology or other explainable diseases are unproven. Interstitial cystitis and hypersensitive bladder severely affect patients' quality of life as a result of disabling symptoms and/or comorbidities. Reported prevalence suggestive of these disorders varies greatly from 0.01% to >6%. Pathophysiology would be an interaction of multiple factors including urothelial dysfunction, inflammation, neural hyperactivity, exogenous substances and extrabladder disorders. Definite diagnosis of interstitial cystitis and hypersensitive bladder requires cystoscopy with or without hydrodistension. Most of the therapeutic options lack a high level of evidence, leaving a few as recommended therapeutic options.

International journal of urology : official journal of the Japanese Urological Association. 2016 May 24 [Epub ahead of print]

Yukio Homma, Tomohiro Ueda, Hikaru Tomoe, Alex Tl Lin, Hann-Chorng Kuo, Ming-Huei Lee, Seung-June Oh, Joon Chul Kim, Kyu-Sung Lee

Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Department of Urology, Ueda Clinic, Kyoto, Japan., Department of Urology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan., Department of Urology, National Yang Ming University and Taipei Veterans General Hospital, Taipei, Taiwan., Department of Urology, Buddhist Tzu Chi General Hospital and School of Medicine, Tzu Chi University, Hualien, Taiwan., Department of Urology, Feng-Yuan Hospital, Taichung, Taiwan., Department of Urology, Seoul National University, Seoul, Korea., Department of Urology, The Catholic University of Korea, Seoul, Korea., Department of Urology, Sung Kyun Kwan University School of Medicine, Seoul, Korea.