Current Perspectives on the Etiology and Emerging Treatments of Interstitial Cystitis/Bladder Pain Syndrome: A Review

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a debilitating, chronic bladder disorder. Because its etiology remains unclear, no curative treatments are currently available, impairing the quality of life. This review provides an overview of the current understanding of the etiologies of IC/BPS subtypes and evaluates emerging treatment strategies for each subtype. IC/BPS is comprised of two distinct subtypes with different pathogenic mechanisms: Hunner lesion disease (HLD) and BPS. HLD is a distinct inflammatory disease subtype of IC/BPS, characterized clinically by the presence of a Hunner lesion and histologically by urothelial denudation and B-cell abnormality. Meanwhile BPS, which lacks a Hunner lesion, is a symptom syndrome complex consisting of multifactorial phenotypes. Recent improvements in understanding of the pathophysiologies of IC/BPS have led to the development of subtype-directed treatment strategies. The broad spectrum of etiology has been a burden for the treatment of IC/BPS and breaking down the subtypes of IC/BPS will lead us to identify novel therapeutic treatments.