Gynecologic Manifestations of Interstitial Cystitis/Bladder Pain Syndrome.

OBJECTIVES

Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is a common source of chronic pelvic pain. The aim of this study was to determine the gynecologic comorbidities associated with bladder pain in the realm of chronic pelvic pain syndromes.

METHODS

The following documents were reviewed in addition to relevant articles. The European Association of Urology guidelines on chronic pelvic pain, the International Continence Society terminology for Pelvic Floor Dysfunction, the International Association for the Society of Pain taxonomy, the Standard for Terminology of Chronic Pelvic Pain Syndromes, and the East Asian International Society of Interstitial Cystitis of Japan guidelines. The gynecologic associated disorders: prevalence, symptoms, signs, evaluation, and management of intra-abdominal, vaginal, pelvic floor muscle, and sexual pain were evaluated.

RESULTS

Gynecologic conditions not associated with IC/BPS were excluded including: Ovarian pathology, adnexal masses, dysmenorrhea, infection, GYN malignancy, and post surgical pain. Endometriosis/adenomyosis affects up to 7% of the population and 70% report pelvic pain and 48% have coexistence with IC/BPS. Vestibulodynia overlaps with bladder pain in 25% of women with IC/BPS. Up to 87% of high tone pelvic floor dysfunction patients have IC/BPS. Dyspareunia occurs in 70% of IC/BPS patients.

CONCLUSIONS

Gynecologic associated disorders with IC/BPS are relevant and need to be identified as pain generators for the diagnosis and management of pain related to IC/BPS. The treatment of all pain generators is key.