European Urology

European Urology

Volume 53, issue 1, pages 1-230, January 2008

Reviews

Diagnostic Criteria, Classification, and Nomenclature for Painful Bladder Syndrome/Interstitial Cystitis: An ESSIC Proposal eulogo1

Joop P. van de Merwe, Jørgen Nordling, Pierre Bouchelouche, Kirsten Bouchelouche, Mauro Cervigni, L. Kurosch Daha, Suzy Elneil, Magnus Fall, Gero Hohlbrugger, Paul Irwin, Svend Mortensen, Arndt van Ophoven, John L. Osborne, Ralph Peeker, Benedikte Richter, Claus Riedl, Jukka Sairanen, Martina Tinzl, Jean-Jacques Wyndaele.

Accepted 10 September 2007, Published online 20 September 2007, pages 60 - 67


Abstract

Objectives

Because the term “interstitial cystitis” (IC) has different meanings in different centers and different parts of the world, the European Society for the Study of Interstitial Cystitis (ESSIC) has worked to create a consensus on definitions, diagnosis, and classification in an attempt to overcome the lack of international agreement on various aspects of IC.

Methods

ESSIC has discussed definitions, diagnostic criteria, and disease classification in four meetings and extended e-mail correspondence.

Results

It was agreed to name the disease bladder pain syndrome (BPS). BPS would be diagnosed on the basis of chronic pelvic pain, pressure, or discomfort perceived to be related to the urinary bladder accompanied by at least one other urinary symptom such as persistent urge to void or urinary frequency. Confusable diseases as the cause of the symptoms must be excluded. Classification of BPS types might be performed according to findings at cystoscopy with hydrodistention and morphologic findings in bladder biopsies. The presence of other organ symptoms as well as cognitive, behavioral, emotional, and sexual symptoms, should be addressed.

Conclusions

The name IC has become misleading and is replaced by BPS. This name is in line with recent nomenclature recommendations by the European Association of Urology and is based on the axial structure of the International Association for the Study of Pain classification. To facilitate the change of the name, ESSIC agreed to include IC in the overall term (BPS/IC) during this transition period.

Take Home Message

The European Society for the Study of Interstitial Cystitis recommends that the name “interstitial cystitis” be changed to “bladder pain syndrome.” A specific definition, diagnostic criteria, and patient evaluation standard are provided.

Keywords: Bladder pain syndrome, BPS, Interstitial cystitis, IC, Chronic pelvic pain, Confusable disease, Diagnostic criteria, Frequency, Hunner's ulcer, Interstitial cystitis, Pain, Painful bladder syndrome, Urgency.


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