Painful Bladder Syndrome’s Diagnostic and Therapeutic Controversies: A Review

Abstract

Painful Bladder Syndrome (PBS) is a controversial disease with no consensus on its nomenclature, diagnostic criteria, or aetiology. Interstitial Cystitis (IC), PBS, chronic pelvic pain syndrome, and Hypersensitive Bladder Syndrome (HBS) are closely related clinical diseases. Hence, underdiagnosis or misdiagnosis of PBS and consequent failure of disease management may occur. This review aims to explore the established and emerging controversies regarding the epidemiology, aetiology, pathogenesis, pathophysiology, clinical presentation, diagnostic criteria, workup and management strategies of PBS. A literature search was carried out in the following electronic databases, PubMed, Scopus, Embase, Google Scholar, Directory of Open Access Journals and Cochrane electronic databases from starting of May to first week of June 2020. Keywords including Bladder Pain Syndrome (BPS), aetiology, histopathology, management and diagnosis were used to search these various databases. Accurate data on the prevalence of PBS is scarce, primarily as there is no standardised definition. Furthermore, there are there no fixed criteria for diagnosis, leading to variability in the reported prevalence of PBS in the literature. Management approaches in patients with PBS must be individualised and tailored to each case in terms of aetiology, diagnosis, and treatment.