This Clinical Review looks at the management of interstitial cystitis or painful bladder syndrome, a chronic condition largely defined by symptoms of urinary urgency and frequency associated with pelvic pain that varies with bladder filling.

This ‘difficult clinical entity’ has prompted debate with regard to definition, aetiology, and best methods of treatment. The authors note that there are few high-quality studies in this area due to ethical difficulties in conducting randomised trials; they have therefore discussed its diagnosis and management “according to evidence representing the majority opinion of researchers as being clinically relevant.”

The review covers the following:

• What is interstitial cystitis and who gets it?
• What causes interstitial cystitis or painful bladder syndrome?
• How is the condition diagnosed?
• Referring to a specialist
• Is the condition related to diet?
• What current treatment approaches have shown benefit? (pentosan polysulfate sodium, heparin, hydroxyzine, amitriptyline, prednisone and ciclosporin)
• What new developments does the future hold to treat this condition?