The Diagnostic and Treatment Patterns of Urologists in the United States for Interstitial Cystitis/Painful Bladder Syndrome

Abstract

IntroductionInterstitial cystitis/bladder pain syndrome is not completely understood, making it challenging to diagnose and treat. The current literature elucidating this disease process is inconsistent. Without a clear consensus regarding management it is important to evaluate how urologists are treating these patients. MethodsUrologists across the United States completed a 19-item survey addressing diagnostic and treatment methods for interstitial cystitis. Participation was voluntary and no compensation was provided to complete the survey. ResultsA total of 95 surveys were completed and returned between December 2012 and January 2013. Of the respondents 92% considered themselves general urologists and most preferred to manage interstitial cystitis/bladder pain syndrome themselves with only 33% referring these patients. Of the respondents 47% believed that the etiology of interstitial cystitis is still unknown. Cystoscopy with hydrodistention was the most common approach to diagnosis (70% of respondents) followed closely by validated symptoms scores (65%). Oral medication was the most commonly used treatment (92% of respondents), of which pentosan polysulfate was the most commonly used agent. Oral medication was followed by intravesical treatment and bladder hydrodistention at 77% and 74% of respondents, respectively. Most urologists ultimately used multimodal therapy. AUA (American Urological Association) guidelines were followed by only 15% of respondent urologists. ConclusionsThe treatment of patients with interstitial cystitis/bladder pain syndrome is variable and many urologists use multiple modalities for diagnosis and treatment. This variability in diagnosis and/or treatment reflects the deficiency of our current understanding of this disease process. Until the pathophysiology is better delineated diagnosis and treatment will remain without consensus.