ABSTRACT
Painful bladder syndrome (PBS), or interstitial cystitis (IC), is a debilitating chronic disease characterized by suprapubic pain related to bladder filling, coupledwith additional symptoms such as increased day-and night-time urinary frequency, without proven urinary infection or other obvious pathology. Although the symptoms presented may appear similar to those of a urinary tract infection, urine culture reveals no underlying infection, and there is no response to antibiotic treatment (1-3). Between 700,000 and 1million people in the United States have IC, the preponderance of whom are women (3). Moreover, it has been estimated that a 60% increase in the number of cases would be identified by experienced clinicians who do not strictly apply the strict National Institute of Diabetes, Digestive, and Kidney Diseases definition of IC (2). While IC may be merely annoying for some patients, when severe, it can render those affected homebound due to extreme urinary frequency (3,4). While the etiology is unknown, theories explaining the pathology of IC include altered barrier lining, afferent, and/or central nervous system (CNS) abnormalities, possible contribution of inflammatory or bacterial agents and abnormal urothelial signaling. These and other factors will be explored in greater detail in this review.
