New Approaches in Managing Interstitial Cystitis/Bladder Pain Syndrome

Amber Jerauld, PharmD, BCACP; Lyndsay Wormuth, PharmD, BCACP; Brent Carlson, PharmD, BCPS, BCCCP

Disclosures

US Pharmacist. 2016;41(9):29-33. 

In This Article

Background

There is controversy surrounding the management of IC/BPS, with no clear consensus for its optimal treatment.[1] The symptoms of IC/BPS vary among patients, with the definitions of the condition and how to measure outcomes varying as well. There is also a lack of randomized, controlled trials.[2] The American Urological Association (AUA) guideline defines IC/BPS as "an unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms of more than six weeks' duration, in the absence of infection or other identifiable causes."[3]

The estimated prevalence of IC/BPS may vary depending on the method used. IC/BPS is more common in women, and a recent estimate shows the female-to-male ratio to be 10:1.[1] It is also more common in Caucasians than in other races.[1] Among adult women in the United States, the estimated prevalence is 2.7% to 6.53%.[3] IC/BPS is often seen in patients with other pain conditions such as allergies, fibromyalgia, or irritable bowel syndrome.[4] According to the National Institutes of Health's (NIH) 2012 publication, Urologic Diseases in America, annual expenditures exclusive of medication costs for Medicare beneficiaries aged ≥65 years was $249,160,233 (specific and nonspecific IC combined).[5]

The recommended treatment approach is to use diagnostic criteria to identify the condition and use a stepwise method to aid in choosing the best therapeutic options based on the individual patient characteristics and severity of their symptoms. The AUA has published guidelines on diagnosis and management of IC/BPS; however, they do emphasize that it is a guideline and is not meant to be interpreted rigidly.[3]

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