Interstitial cystitis (IC)/chronic pelvic pain syndrome is a chronic, often unrecognized, lower urinary tract disease.

Primary symptoms include one or more of the following: urinary frequency, urinary urgency, and pelvic pain. Other symptoms include nocturia, dysuria, dyspareunia, and testicular, scrotal, and perineal pain. 1-4

IC is much more common than previously thought. Based on recent data, as many as 1 in 5 women in the United States may be affected. 5,6

A substantial number of men diagnosed with chronic prostatitis actually have IC. 7,8

IC is potentially caused by bladder epithelial dysfunction, which leads to diffusion of urinary solutes (potassium) into the bladder interstitium, tissue injury, and inappropriate afferent nerve stimulation. 9–12

Evaluation should include history with validated symptom questionnaire, physical examination, urinalysis, and urine culture. Additional tests include the potassium sensitivity test, 10 cystoscopy, and urodynamics.

Several efficacious treatments exist, including pentosan polysulfate, hydroxyzine, amitriptyline, and intravesical heparin.

Urinary diversion should be considered only in patients with severe disease refractory to less-invasive therapies.