ABSTRACT
Managing patients with urgency frequency and pelvic pain syndrome/interstitial cystitis is one of the greatest challenges facing physicians and other healthcare providers who treat those with this disorder. The symptoms of urgency, frequency, dysuria, and chronic pelvic pain characterize interstitial cystitis (IC), but it is often the debilitating pelvic pain associated with interstitial cystitis that is the most difficult to control. The pathophysiology of IC is poorly understood, but is thought to be a complex entity involving inflammatory and immunologic components. Currently there are no single universally effective therapies available; however, oral treatments frequently used include antimuscarinics, nonsteroidal anti-inflammatory drugs (NSAIDs), tricyclic antidepressants, gabapentin, and pentosan polysulfate, all of which have varying degrees of efficacy. The recognition that the pain of IC is multifactorial, probably with a neuropathic component, has led to the effective use of some of these agents that have previously been prescribed for various neurologic conditions associated with chronic pain. Intravesical and surgical options are also available, which expands the armamentarium for those who treat patients with this perplexing disease. Treating IC requires managing all of the symptoms of this disease.
