Interstitial Cystitis/Bladder Pain Syndrome: Matching Therapies to the Patient

被引:0
作者
Moldwin, Jennifer Fariello [1 ]
Moldwin, Robert M. [2 ]
机构
[1] Northwell Hlth, Dept OB GYN, Div Urogynecol, 376 E Main St,Suite 201, Bay Shore, NY 11706 USA
[2] Northwell Hlth, Zucker Sch Med Hofstra Northwell, Arthur Smith Inst Urol, Lake Success, NY USA
关键词
Interstitial cystitis; Bladder pain syndrome; Phenotyping; Targeted therapies; Clinical guidelines; Clinical outcomes; CYSTITIS/PAINFUL BLADDER SYNDROME; PENTOSAN POLYSULFATE SODIUM; DOUBLE-BLIND; SYNDROME/INTERSTITIAL CYSTITIS; MULTIDISCIPLINARY APPROACH; BOTULINUM-TOXIN; FEMALE-PATIENTS; WOMEN; DYSFUNCTION;
D O I
10.1007/s11884-025-00772-y
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose of ReviewWe intend to establish broad clinical subgroups of patients and match them to a more tailored approach with improved clinical outcomes.Recent FindingsPatient experience over the past four decades and investigative initiatives such as The Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) have led to the development of four broad categories of IC/BPS patients: bladder-centric (which is further sub-divided into those with Hunner lesion disease (HLD) and those without (IC/BPS)); widespread/centralized pain; and myofascial pelvic floor tenderness. Other systems of patient categorization, such as UPOINT, now INPUT, highlight the complexities of patient assessment.Reanalysis of previous failed clinical trials and common sense suggests that matching the therapy's mechanism of action to the patient's phenotype may yield better therapeutic outcomes.Recent FindingsPatient experience over the past four decades and investigative initiatives such as The Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) have led to the development of four broad categories of IC/BPS patients: bladder-centric (which is further sub-divided into those with Hunner lesion disease (HLD) and those without (IC/BPS)); widespread/centralized pain; and myofascial pelvic floor tenderness. Other systems of patient categorization, such as UPOINT, now INPUT, highlight the complexities of patient assessment.Reanalysis of previous failed clinical trials and common sense suggests that matching the therapy's mechanism of action to the patient's phenotype may yield better therapeutic outcomes.SummaryAlthough the IC/BPS population is known to be phenotypically heterogeneous, therapeutic approaches afforded by most current guidelines have been relatively rigid, only accounting for those patients with and without Hunner lesions. Segregating the IC/BPS population further into distinct phenotypic groups that may respond to targeted therapy is relatively simplistic but represents an essential first step toward precision care.
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