title: Clinical presentation and treatment of bladder pain syndrome/interstitial cystitis (BPS/IC) in India.
abstract: Bladder pain syndrome/interstitial cystitis (BPS/IC) is a chronic disease characterized by pelvic pain urgency and frequency. Patients with severe symptoms lead a very miserable life. North American, European and Asian guidelines have been recently promulgated but they differ on many important issues. There is no consensus on its name, definition, investigations and management. Indian guidelines have also been developed and they give more importance to the symptoms in relation to micturition. Though initially believed to be rare or non-existent in India the situation has changed. In Indian patients the presentation is more or less same as the rest of the world but a large percentage have obstructive symptoms and unusual urinary symptoms. Anal discomfort is also common. In India the commonest investigation in all cases of lower urinary tract (LUT) dysfunction is ultrasonography of kidney ureter and bladder with measurement of the post void residual urine volume. Cystoscopy is also done in all the cases to rule out presence of tuberculosis or carcinoma in situ. Bladder pain syndrome/interstitial cystitis (BPS/IC) is not considered to be a clinical disease as it is difficult to rule out all differential diagnosis only from history. Hunner's lesion is very rare. Cystoscopy with hydro distension, oral therapy, intravesical therapy and surgical therapy form the back bone of management. It is difficult to know which treatment is best for a given patient. A staged protocol is followed and all the treatment modalities are applied to the patients in a sequential fashion-starting from the non-invasive to more invasive. Intravesical botox has not been found to be effective and there is no experience with interstim neuromodulation.
authors.affiliation: Department of Urology, Kidney And Urology Hospital, Gujarat, India.
authors.forename: Nagendra Nath
authors.initials: NN
authors.lastname: Mishra
keywords: Interstitial cystitis (IC); bladder pain syndrome (BPS); mandatory investigations; refractory disease; staged treatment
references.citation: Urology. 1998 Sep;52(3):417-21
references.pmid: 9730453
references.citation: Urology. 1997 May;49(5A Suppl):81-5
references.pmid: 9146006
references.citation: J Urol. 2000 Dec;164(6):1908-11
references.pmid: 11061878
references.citation: Eur Urol. 2008 Jan;53(1):60-7
references.pmid: 17900797
references.citation: J Urol. 2002 Jun;167(6):2470-2
references.pmid: 11992059
references.citation: Curr Opin Obstet Gynecol. 2000 Oct;12(5):405-10
references.pmid: 11111883
references.citation: BJU Int. 2000 May;85(8):995-9
references.pmid: 10792194
references.citation: J Urol. 1988 Jul;140(1):203-6
references.pmid: 3379688
references.citation: Urology. 2001 Mar;57(3):428-32; discussion 432-3
references.pmid: 11248610
references.citation: Urol Clin North Am. 2007 Feb;34(1):61-9
references.pmid: 17145362
references.citation: Int J Urol. 2009 Jul;16(7):597-615
references.pmid: 19548999
references.citation: J Urol. 2005 Dec;174(6):2235-8
references.pmid: 16280777
references.citation: J Pediatr Adolesc Gynecol. 2004 Feb;17(1):7-11
references.pmid: 15010032
references.citation: Urology. 2001 Jun;57(6 Suppl 1):47-55
references.pmid: 11378050
references.citation: Urology. 2000 Dec 20;56(6):940-5
references.pmid: 11113737
references.citation: J Urol. 1998 Jan;159(1):83-5
references.pmid: 9400442
references.citation: J Urol. 1998 Nov;160(5):1663-7
references.pmid: 9783927
references.citation: Curr Drug Targets Inflamm Allergy. 2002 Mar;1(1):89-108
references.pmid: 14561209
references.citation: Int Urogynecol J Pelvic Floor Dysfunct. 2000;11(5):290-5
references.pmid: 11052564
references.citation: Rev Urol. 2002;4 Suppl 1:S16-20
references.pmid: 16986029
references.citation: J Urol. 2011 Aug;186(2):540-4
references.pmid: 21683389
references.citation: J Urol. 1981 Aug;126(2):200-4
references.pmid: 7265366
references.citation: Urology. 1987 Apr;29(4 Suppl):31-3
references.pmid: 3564231
references.citation: J Urol. 2001 Nov;166(5):1951-6
references.pmid: 11586266
references.citation: J Urol. 1987 Jan;137(1):35-8
references.pmid: 3795363
references.citation: J Urol. 2004 Aug;172(2):478-80
references.pmid: 15247708
references.citation: Expert Opin Med Diagn. 2013 Jan;7(1):17-24
references.pmid: 23530841
references.citation: Neurourol Urodyn. 2009;28(1):22-5
references.pmid: 18671294
references.citation: J Urol. 1994 Nov;152(5 Pt 1):1641-5
references.pmid: 7933221
references.citation: J Urol. 2011 Jun;185(6):2162-70
references.pmid: 21497847
references.citation: J Urol. 2004 Mar;171(3):1148-50; discussion 50-1
references.pmid: 14767289