How is pain managed in patients with interstitial cystitis/bladder pain syndrome (IC/BPS)?

Updated: Dec 04, 2020
  • Author: Eric S Rovner, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Managing the pain component can be difficult in patients with interstitial cystitis. The etiology of the pain remains unclear, but various authors have postulated the etiology to be mediated centrally, peripherally, or locally via a neurogenic or inflammatory mechanism. Increasing evidence has implicated central mechanisms and sensitization in women with interstitial cystitis/bladder pain syndrome (IC/BPS). A recent study by Lai et al showed segmental hyperalgesia to mechanical stimulation in patients with IC/BPS. [76]

Additionally, it has been shown that there is excessive adrenergic stimulation in patients with IC/BPS, and iatrogenic stimulation shows heightened response in IC/BPS patients with pathologic findings of increased mucosal mastocytosis and increased sympathetic nerve density. [77]

Some patients require long-term pain medications, while others rely on these only during periods of symptomatic flares.


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