Diagnosis of interstitial cystitis/bladder pain syndrome: Guidelines from the Committee of Female Urology (CUROPF) of the French Association of Urology (AFU).

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic condition whose diagnosis relies primarily on a structured process of exclusion. Defined as chronic pelvic pain, pressure, or discomfort perceived in relation to the bladder, accompanied by at least one urinary symptom, IC/BPS encompasses significant clinical and pathophysiological heterogeneity. A thorough medical history, targeted physical examination, and validated questionnaires such as the O'Leary-Sant score (ICSI/ICPI) form the foundation of initial evaluation. Patient phenotyping - distinguishing in particular the bladder-centric from the sensitization phenotype - is essential to guide both diagnostic and therapeutic strategies. Complementary investigations include a voiding diary, urine culture, imaging (ultrasound as first-line, CT scan and MRI as second-line modalities), and cystoscopy (preferably with hydrodistension under general anesthesia), which allows identification of Hunner's lesions, measurement of anatomical bladder capacity, and targeted biopsies. Urodynamic testing is reserved for cases of diagnostic uncertainty or associated voiding dysfunction. These recommendations aim to standardize the diagnostic approach in order to optimize individualized management in patients suffering from IC/BPS.