Treatment of interstitial cystitis/bladder pain syndrome: Guidelines from the Committee of Female Urology (CUROPF) of the French Association of Urology (AFU).

Abstract

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a complex chronic condition requiring a multimodal and individualized management approach. This article presents current treatment recommendations for IC/BPS, covering the full therapeutic spectrum from lifestyle and dietary measures to last-resort surgical options. Behavioral interventions, patient education, pelvic floor physical therapy, and psychological support form the cornerstone of first-line management. When these measures prove insufficient, pharmacological treatments - including conventional and atypical analgesics, as well as systemic oral therapies such as pentosan polysulfate sodium - along with intravesical instillations of glycosaminoglycans or dimethyl sulfoxide, may be considered. Interventional techniques, including hydrodistension, intravesical injections of onabotulinumtoxinA, and sacral neuromodulation, represent effective options for refractory patients. Excisional surgery and urinary diversion remain reserved for a carefully selected subgroup of patients presenting with severe, documented bladder-centric disease. Rigorous phenotypic patient selection is the cornerstone of all therapeutic decisions and the principal determinant of prognosis.