M Esteban1, J M Adot2, S Arlandis3, L Peri4, L Prieto5, J Salinas6, J M Cozar7. 1. Servicio de Urología, Hospital Nacional de Parapléjicos, Toledo, España. Electronic address: ESTEBOTE@telefonica.net. 2. Servicio de Urología, Hospital General Universitario, Burgos, España. 3. Servicio de Urología, Hospital Universitari i Politècnic la Fe, Valencia, España. 4. Servicio de Urología, Hospital Clínico de Barcelona, Barcelona, España. 5. Servicio de Urología, Hospital Universitario de Elche, Alicante, España. 6. Servicio de Urología, Hospital Clínico San Carlos, Madrid, España. 7. Servicio de Urología, Hospital Virgen de las Nieves, Granada, España.
Abstract
INTRODUCTION: Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC) and other bladder pathologies share common manifestations, such as the presence of mictional symptoms and a negative impact on the patient's quality of life. To be properly diagnosed and clinically managed, it is important to distinguish between its clinical modalities and diagnostic criteria for adequate exclusion. OBJECTIVE: The purpose of this study was to standardize criteria for making decisions in BPS management, for its diagnosis, initial treatment and follow-up. MATERIAL AND METHOD: A nominal group methodology was employed, using scientific evidence on BPS taken from a systematic (non-exhaustive) literature review for developing recommendations along with specialist expert opinions. RESULTS: The diagnosis of BPS should be made based on the patient's clinical history, with emphasis on pain and mictional symptoms as well as excluding other pathologies with similar symptomatology. BPS treatment should be directed towards restoring normal bladder function, preventing symptom relapse and improving patients' quality of life. It is therefore advisable to start with conservative treatment and to adopt less conservative treatments as the level of clinical severity increases. It is also recommended to abandon ineffective treatments and reconsider other therapeutic options. CONCLUSIONS: Quickly identifying the pathology is important when trying to positively influence morbidity and care quality for these patients.
INTRODUCTION: Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC) and other bladder pathologies share common manifestations, such as the presence of mictional symptoms and a negative impact on the patient's quality of life. To be properly diagnosed and clinically managed, it is important to distinguish between its clinical modalities and diagnostic criteria for adequate exclusion. OBJECTIVE: The purpose of this study was to standardize criteria for making decisions in BPS management, for its diagnosis, initial treatment and follow-up. MATERIAL AND METHOD: A nominal group methodology was employed, using scientific evidence on BPS taken from a systematic (non-exhaustive) literature review for developing recommendations along with specialist expert opinions. RESULTS: The diagnosis of BPS should be made based on the patient's clinical history, with emphasis on pain and mictional symptoms as well as excluding other pathologies with similar symptomatology. BPS treatment should be directed towards restoring normal bladder function, preventing symptom relapse and improving patients' quality of life. It is therefore advisable to start with conservative treatment and to adopt less conservative treatments as the level of clinical severity increases. It is also recommended to abandon ineffective treatments and reconsider other therapeutic options. CONCLUSIONS: Quickly identifying the pathology is important when trying to positively influence morbidity and care quality for these patients.
Authors: Pradeep Tyagi; Chan-Hong Moon; Joseph Janicki; Jonathan Kaufman; Michael Chancellor; Naoki Yoshimura; Christopher Chermansky Journal: F1000Res Date: 2018-11-09