Management of patients with interstitial cystitis or chronic pelvic pain of bladder origin: a consensus report.
BACKGROUND
Interstitial cystitis (IC) remains a challenging disease to treat, but increased awareness, better diagnostic tools, and effective pharmacologic agents can help non-urologists successfully manage this condition. Interstitial cystitis is much more prevalent than previously thought and is often misdiagnosed. Left untreated, IC can have a deleterious effect on the quality of life of the affected individual. In-office symptom-based techniques have been developed to screen for the presence of IC in both women and men presenting with symptoms of chronic pelvic pain (CPP) or chronic prostatitis (CP), and effective pharmacologic treatments exist that can provide acute and long-term symptom relief. Individual patient response to therapy varies, with some patients taking up to several months to achieve an optimal therapeutic response. To optimize patient response, a comprehensive algorithm for the diagnosis and management of IC should be utilized. Symptoms and progress should be assessed at each follow-up visit and changes in therapy made accordingly. Patients should be encouraged to learn as much as possible about IC and to take charge of the management of symptoms using their physician for guidance in decision making. The importance of this aspect of therapy should be reinforced at each subsequent visit. The entire office staff also has an important role in understanding and acknowledging each patient's pain and frustration as well as in providing support and education about IC.


METHODS
This paper presents recommendations from a multidisciplinary panel for the evaluation, diagnosis, treatment, and follow-up care of patients with IC or CPP of bladder origin.
Kahn
Bruce S
BS
Department of Obstetrics and Gynecology, Scripps Clinic and Research Institute, University of California San Diego, CA, USA. bkahn@ucsd.edu
Stanford
Edward J
EJ
Mishell
Daniel R
DR
Rosenberg
Matt T
MT
Wysocki
Susan
S
D002908:Chronic Disease; D018856:Cystitis, Interstitial / Q000175:diagnosis / Q000628:therapy*; D003657:Decision Making; D006801:Humans; D010146:Pain / Q000209:etiology*; D010347:Patient Care Planning; D010388:Pelvis / Q000473:pathology; D011788:Quality of Life; D012307:Risk Factors; D001743:Urinary Bladder / Q000473:pathology