Global Consensus on Interstitial Cystitis/Bladder Pain Syndrome: An Update on Therapeutic Treatments

AIMS: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic condition marked by chronic pain and voiding dysfunction, often without a clear cause. Management of which often requires a multidisciplinary approach, as well as multiple therapeutic interventions. METHODS: This review characterizes mechanisms and limitations of currently available treatment modalities for IC/BPS, as well as novel and investigational therapies. RESULTS: Conservative and supportive therapies include cognitive therapies, dietary and fluid management, pelvic floor exercises and bladder training. Additionally, pelvic floor directed therapies such as physical therapy, injections and nerve blocks should be considered. Cystoscopy with hydrodistension is both a diagnostic and therapeutic intervention. Currently available oral therapies include: pentosan polysulfate, amitriptyline, hydroxyzine, silodosin, and non-opioid medications such as cyclobenzaprine. Immunotherapies include cyclosporine and tacrolimus. Available intravesical therapies include dimethyl sulfoxide, lidocaine, oxybutynin, and glycosaminoglycan substitution treatment. Neuromodulation is also available including sacral and pudendal neuromodulation. Finally, we explore emerging therapies and drug delivery systems. CONCLUSIONS: In this review, we present currently available treatment options for IC/BPS. These include conservative therapies, oral medications, intravesical therapies, and neuromodulation. Novel and investigational therapies are presented as well as promise for future directions.