Promoting the Self-Management of Women with IC/BPS: Insights into International Guidelines (Systematic Review).

INTRODUCTION AND HYPOTHESIS: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic condition characterized by bladder pain and lower urinary tract symptoms, predominantly affecting women and significantly impairing quality of life. Particularly in the absence of reliable knowledge about etiology and appropriate treatment of IC/BPS, clinical practice guidelines (CPGs) emphasize self-management as a key element of care. This review was aimed at comparing recommendations from CPGs, focusing on interventions to facilitate the self-management of women with IC/BPS.

METHODS

A systematic review was conducted following a preregistered protocol. Databases and libraries MEDLINE, Guidelines International Network, Cochrane Library, National Institute for Health and Care Excellence, and Scottish Intercollegiate Guidelines Network were searched. Data extraction focused on interventions facilitating self-management, following the definition according to Corbin and Strauss. Recommendations were categorized and presented with grade of recommendation and level of evidence. CPG quality was appraised using the Appraisal of Guidelines for Research & Evaluation II instrument.

RESULTS

Eight CPGs from Europe, North America, and Asia were included. All emphasized self-management as essential for IC/BPS care and contained recommendations across ten core categories, including dietary modification, bladder training, multimodal pain management, stress management, sexual health, and others. Although certain interventions such as physiotherapy referral and bladder diaries were frequently recommended, overall consistency and strength of evidence were limited.

DISCUSSION: Although some consensus exists, recommendations vary in focus and often lack strong evidence. Gender-specific aspects are rarely addressed. These findings highlight the need for more consistent, evidence-informed, and patient-centered CPGs that explicitly account for the gendered and biographical dimensions of living with IC/BPS.