AUA issues first guideline on interstitial cystitis/bladder pain syndrome

The AUA has released its first clinical guideline on the diagnosis and treatment of interstitial cystitis/bladder pain syndrome (IC/BPS).

The new guideline is designed to present a clinical strategy for physicians, and the guideline panel notes that the most effective approach for a specific case should be determined by individual patients and their clinician.

Panel experts recommend the following assessments for both women and men:

• a full basic assessment, including a careful history, physical examination, and laboratory examination to identify characteristic IC/BPS symptoms and rule out confusable disorders
• measurements of baseline voiding symptoms and pain levels
• the consideration of cystoscopy and/or urodynamic studies to better assess complicated presentations or to confirm a diagnosis when assessment results are in doubt.

The panel outlines the following key clinical principles for first-line treatment:

• Strategies should start with the most conservative treatments before moving to less conservative therapies.
• Initial treatment type and level should be related to symptom severity, clinical judgment, and patient preferences.
• Some patients may benefit from multiple, concurrent treatments.
• Ineffective treatments should be stopped once a clinically meaningful interval has elapsed.
• Pain management and its impact on a patient’s quality of life should be regularly assessed and considered.
• If no improvement in symptoms occurs after multiple treatment approaches, the diagnosis should be reconsidered.
• Patients should be counseled on how certain self-care practices, behavioral modifications, and coping techniques may help manage their IC/BPS symptoms.

"IC/BPS affects a significant number of patients whose quality of life is severely diminished by this complicated, frustrating condition," said Philip M. Hanno, MD, MPH, of the University of Pennsylvania, Philadelphia, who chaired the multidisciplinary panel that developed the guideline. "This population has historically been both under-recognized and underserved, and it is our hope that this guideline provides physicians with a much-needed roadmap to help treat these patients."

A complete executive summary of the guideline will be published in an upcoming issue of the Journal of Urology, and a Webinar about the guideline will also be made available online at www.AUAnet.org. Look for a more detailed report on the guideline in an upcoming issue of Urology Times.