Chronic pelvic pain of bladder origin: epidemiology, pathogenesis and quality of life.

Interstitial cystitis (IC) is chronic pelvic pain of bladder origin that is far more common than previously thought. Although prevalence estimates vary greatly, studies consistently indicate that IC affects approximately 20% of women. The pathogenesis remains unknown but is thought to be multifactorial. Many women with IC have an abnormality of the bladder surface; ongoing exposure to urine solutes permeates the urothelium and causes significant pain and inflammation. The increased number of C-fibers and increased amount of substance P found in IC patients also contribute to the inflammation and pain associated with this condition. Long-standing and/or severe disease significantly impairs the ability to work and quality of life among IC patients. The physical and psychological consequences of IC should be a "call to arms" for clinicians to promptly and accurately diagnose and manage IC.