Diagnostic approach for suspected interstitial cystitis/bladder pain syndrome in adults

The diagnosis of IC/BPS is made in patients with 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.

IC/BPS: interstitial cystitis/bladder pain syndrome; UTI: urinary tract infection; STI: sexually transmitted infection.
* Structural disease includes urethral diverticula, urogenital prolapse, uterine/cervical mass, inguinal hernia, prostate mass, or eroded/exposed vaginal mesh. Exquisite tenderness may make it impossible to perform an adequate pelvic or rectal examination. In this situation, for patients who meet diagnostic criteria for IC/BPS, clinicians may choose to begin empiric treatment and to defer full examination until symptoms have improved to the point where examination is possible.
¶ Urine tests include urinalysis and culture if indicated, as well as testing for chlamydia and gonnorhea in sexually active patients. Postvoid residual urine volume should be measured either by using a catheter (usually avoided due to associated pain) or by ultrasound
Δ Other tests may include urine cytology and upper tract imaging.
◊ Cystoscopy may reveal Hunner lesions, which are consistent with IC/BPS.

Graphic 121778 Version 1.0

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Diagnostic approach for suspected interstitial cystitis/bladder pain syndrome in adults