Updates have been issued to guidelines on diagnosing and treating interstitial cystitis and bladder pain by the American Urological Association.
The basic assessment should include a careful history, physical examination, and laboratory examination to rule in symptoms that characterize interstitial cystitis/bladder pain syndrome (and rule out other disorders). Baseline voiding symptoms and pain levels should be obtained in order to measure subsequent treatment effects.
Overall management should initially focus on conservative therapies including patient education, behavior modification, and stress management. Treatment, including pain management, is determined by symptom severity, clinician judgment, and patient preferences.
Second-line treatments include manual physical therapy techniques, oral medications (amitriptyline, cimetidine, hydroxyzine, or pentosan polysulfate), and intravesical treatments (dimethyl sulfoxide, heparin, or lidocaine). Third-line treatments are cystoscopy under anesthesia with short-duration, low-pressure hydrodistension, fulguration, and injection of triamcinolone, the guidelines state.
Find the full guideline sat the Agency for Healthcare Research and Quality website.