Neurourology and Urodynamics最新文献

{"title":"Genomics and Histopathology in Interstitial Cystitis/Bladder Pain Syndrome.","authors":"Hannah Ruetten, LaTasha K Crawford, Elise J B De, Wencheng Li, Yoshiyuki Akiyama","doi":"10.1002/nau.70117","DOIUrl":"10.1002/nau.70117","url":null,"abstract":"<p><strong>Aims: </strong>In April of 2025, a Global Consensus meeting on IC/BPS was held in Winston-Salem, NC. The goal of this meeting was to establish global consensus in diagnostic criteria, phenotyping, treatment outcome assessment, and possible etiopathology in interstitial cystitis/bladder pain syndrome (IC/BPS). Our sub-committee focused on developing a consensus document on histopathology in IC/BPS.</p><p><strong>Methods: </strong>Narrative review.</p><p><strong>Results: </strong>Herein we discuss histological and molecular distinctions of Hunner lesion disease (HLD) and non-Hunner lesion disease (non-HLD) in IC/BPS, including urothelial alterations, inflammatory changes, vascularization and fibrosis, and neurophysiological dysfunction. The molecular and histological characteristics of HLD make it distinct from non-HLD. HLD is histologically characterized by urothelial denudation and subepithelial chronic inflammation featured by B-cell dominant lymphoplasmacytic infiltration, while non-HLD shows subtle inflammatory changes with preserved urothelial layers. Some cases of non-HLD reflect a component of multi-systemic pain syndrome driven by altered neurophysiological networks within the central or peripheral nervous system.</p><p><strong>Conclusions: </strong>Molecular and histological characteristics revealed that HLD and non-HLD are distinct disease entities as the former is an inflammatory disease of the urinary bladder and the latter may be represented by systemic neurophysiological disorder, rather than pathology that is limited to the bladder. This concept could be useful in phenotyping, diagnosis, and development of biomarkers for IC/BPS.</p><p><strong>Trial registration: </strong>No new data were generated for this manuscript; no clinical trial was conducted.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower Urinary Tract Symptoms in Male Patients With Multiple Sclerosis: Prevalence and Associations With Quality of Life, Depression, and Anxiety.","authors":"Yesim Akkoc, Bedriye Karaman, Asli Koskderelioglu, Ozgul Ekmekci, Neslihan Eskut, Nur Yuceyar","doi":"10.1002/nau.70118","DOIUrl":"https://doi.org/10.1002/nau.70118","url":null,"abstract":"<p><strong>Purpose: </strong>Lower urinary tract symptoms (LUTS) are frequent in male patients with multiple sclerosis (MS). This study was planned to investigate the frequency and distress of LUTS in men with MS and their association with quality of life (QoL), depression, and anxiety.</p><p><strong>Methods: </strong>One hundred male patients with MS were included in the study. The International Incontinence Consultation Questionnaire-Male LUTS questionnaire (ICIQ-MLUTS) was used to investigate LUTS. The King's Health questionnaire (KHQ) was used to evaluate QoL and the Hospital Anxiety and Depression (HAD-A, HAD-D) scale was used to evaluate depression and anxiety.</p><p><strong>Results: </strong>A total of 100 men with an average age of 39.3 ± 9.3 (range, 20-63) years were evaluated. The mean disease duration was 9.3 ± 6.0 (range, 1-26) years. The mean EDSS score was 2.2 ± 1.8 (median: 2, range: 0-6.5). A total of 91% of patients reported at least one LUTS. The most common storage symptoms were urgency and urgency urinary incontinence (IU), and the most common voiding symptoms were incomplete emptying, hesitancy, and intermittency. ICIQ-MLUTS incontinence and voiding scores were significantly correlated with disease duration, EDSS, HAD-A, HAD-D, and all KHQ subgroups, except general health perceptions.</p><p><strong>Conclusions: </strong>LUTS, including storage and voiding symptoms, were highly prevalent in male MS patients and significantly correlated with reduced QoL, increased HAD-D and HAD-A scores.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) Diagnosis: Current Limitations and a Pragmatic Clinical Diagnostic Definition.","authors":"Glenn T Werneburg, Robert Moldwin, C Lowell Parsons, M Shivam Priyadarshi, Sanjay Sinha, J Quentin Clemens","doi":"10.1002/nau.70112","DOIUrl":"https://doi.org/10.1002/nau.70112","url":null,"abstract":"<p><strong>Objective: </strong>To develop a consensus on diagnostic criteria for interstitial cystitis/bladder pain syndrome (IC/BPS).</p><p><strong>Materials and methods: </strong>A subcommittee was identified based on expertise in IC/BPS diagnostic criteria. An outline was generated and iteratively modified until it was found to be acceptable by subcommittee members as the basis for manuscript generation. The manuscript was presented and revised in two iterations according to feedback from international key opinion leaders at the Global Consensus on IC/BPS and the AUA Annual Meeting, respectively.</p><p><strong>Results: </strong>The patient history and physical examination are necessary components in the diagnosis of IC/BPS. Urinalysis and urine culture are necessary laboratory tests to rule out exclusionary conditions including active infection. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) criteria, which were established in 1988 for research purposes, pose several limitations and result in the exclusion of a large proportion of IC/BPS patients when applied clinically. Thus, we put forth a pragmatic and streamlined definition that is aligned with existing clinical guidance and standard diagnostic workup.</p><p><strong>Conclusions: </strong>The clinical diagnosis of IC/BPS is based on history, physical examination, and urine studies. IC/BPS is clinically defined as an unpleasant sensation (e.g. pain, discomfort, pressure, burning) that worsens with bladder filling and improves with bladder emptying, of 3 or more months duration, in the absence of exclusionary diagnoses that would likely account for the symptomatology. A substantial number of IC/BPS patients have comorbid pelvic disorders (e.g., pelvic floor dysfunction, vulvodynia, endometriosis) which require separate treatment.</p><p><strong>Trial registration: </strong>This study is not a clinical trial and thus does not warrant registration as such.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of Preoperative Urodynamics on Management in Women With Pelvic Organ Prolapse.","authors":"Apisith Saraluck, Jittima Manonai","doi":"10.1002/nau.70115","DOIUrl":"https://doi.org/10.1002/nau.70115","url":null,"abstract":"<p><strong>Importance: </strong>The role of preoperative urodynamic studies (UDS) in women undergoing pelvic organ prolapse (POP) surgery remains controversial, especially regarding their influence on surgical planning and patient counseling.</p><p><strong>Objective: </strong>To evaluate the impact of preoperative UDS on changes in surgical management and counseling among women with advanced-stage POP undergoing surgical repair.</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Setting: </strong>Tertiary urogynecology center at Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.</p><p><strong>Participants: </strong>A total of 118 women with POP-Q stage III or IV who underwent UDS before planned POP surgery between July 2018 and July 2023.</p><p><strong>Interventions: </strong>All participants underwent standardized multichannel UDS, including POP reduction during testing, based on institutional protocol and international guidelines.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was the proportion of cases in which UDS findings led to changes in surgical or medical management. Secondary outcomes included the role of UDS in enhancing preoperative counseling and identifying discrepancies between symptoms and objective findings.</p><p><strong>Results: </strong>The mean age of participants was 69.4 years (SD 7.7), with 97.5% being postmenopausal. UDS altered clinical management in 23 cases (19.5%). Notable changes included the addition or omission of anti-incontinence procedures and initiation of OAB treatment. UDS also enhanced the preoperative counseling process, contributing to informed decision-making in 67 patients (56.8%) and excluding misleading symptoms in 69 cases (58.5%), such as absence of detrusor overactivity in OAB or detrusor underactivity in voiding dysfunction.</p><p><strong>Conclusions and relevance: </strong>Preoperative UDS led to management changes in approximately one in five patients with advanced POP, particularly those with SUI, occult SUI, or voiding dysfunction. Although major surgical changes were infrequent, UDS provided significant value for patient counseling and risk stratification. These findings support a more selective and context-specific approach to the use of UDS in POP surgical planning.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interstitial Cystitis/Bladder Pain Syndrome: Why a Global Patient Registry Is Critically Needed.","authors":"Christina Mezes, Aya Niimi, George Kasyan, Amy D Dobberfuhl, Sachin Malde","doi":"10.1002/nau.70114","DOIUrl":"https://doi.org/10.1002/nau.70114","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this article is to establish expert consensus on the rationale for, and components of, a global patient registry for interstitial cystitis/bladder pain syndrome (IC/BPS). Our goal is to highlight what a comprehensive international patient registry can add to the growing body of IC/BPS-focused research and summarize the committee's rationale for inclusion or exclusion of certain patient and diagnostic characteristics to identify sub-groups of patients who will benefit from targeted therapy.</p><p><strong>Materials and methods: </strong>An expert working group was formed from members of the Global Consensus on IC/BPS meeting. The working group consisted of four Urologists and a Urogynaecologist, and held a series of meetings in 2025 to achieve consensus on the benefits, hurdles and practical aspects of developing a global registry for IC/BPS. Literature search of the PubMed database was also performed where relevant, and all members agreed on the final proposals.</p><p><strong>Results: </strong>The framework for an IC/BPS global registry was developed inclusive of male and female patients ages 18 years and older, who have symptoms of pain, pressure or discomfort related to the bladder, along with lower urinary tract symptoms, that have persisted for 3 or more months, in the absence of confusable disorders. A comprehensive list of patient data points including demographic, history-related, and comorbid conditions was developed. Additionally, validated questionnaires were identified for inclusion that assess domains of pain, urinary symptoms and quality of life. Consensus was reached regarding collecting data on prior treatment, cystoscopy findings and biopsy results where applicable. Lastly, importance was placed on patient-reported questionnaire data that can be input longitudinally by patients to lessen the burden of data collection by providers. Technical, legal and financial aspects were addressed as potential barriers.</p><p><strong>Conclusions: </strong>A global registry for IC/BPS would overcome the limitations of current regional registries by including large numbers of patients from varied geographical locations, allowing for more efficient recruitment of patients for clinical trials. Understanding epidemiological trends and global variation in practice would enable optimization of care and quality improvement worldwide.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detrusor Overactivity and Urodynamics.","authors":"Laura N Nguyen, Geneviève Nadeau","doi":"10.1002/nau.70113","DOIUrl":"https://doi.org/10.1002/nau.70113","url":null,"abstract":"<p><p>While overactive bladder (OAB) is a clinical diagnosis, detrusor overactivity is identified through urodynamic testing. UDS is usually considered when primary treatment for OAB fails, because UDS is expensive, time consuming, invasive, and sometimes inaccurate, and it is not considered to influence treatment strategy substantially. On the other hand, UDS helps for diagnosis and treatment among women with OAB symptoms, and plays a key role in diagnosing DO to properly assess bladder function for complex LUTS situations such as nocturnal enuresis, bladder outlet obstruction, detrusor underactivity or after surgical correction of stress urinary incontinence. This article emphasizes the vital role of urodynamics in diagnosing and managing DO, highlighting its significance in treatment planning and the need for further research to refine diagnostic criteria and therapeutic strategies.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interstitial Cystitis/Bladder Pain Syndrome in Men.","authors":"Madeline Snipes, Wyatt Whitman, Michel Pontari, Jennifer Anger, Michael Samarinas, Rajesh Taneja","doi":"10.1002/nau.70103","DOIUrl":"https://doi.org/10.1002/nau.70103","url":null,"abstract":"<p><strong>Aims: </strong>In April 2025, the Wake Forest Institute for Regenerative Medicine hosted a Global Consensus meeting on interstitial cystitis/bladder pain syndrome (IC/BPS) in Winston-Salem, NC. The goal of this meeting was to establish attainable targets in phenotyping, diagnosis, and biomarkers for IC/BPS. Our subcommittee focused on developing a consensus document addressing IC/BPS in men.</p><p><strong>Methods: </strong>Narrative review.</p><p><strong>Results: </strong>Within this document, we discuss prevalence, clinical characteristics, evaluation/investigation, and treatment of IC/BPS in men. The is limited literature specifically addressing IC/BPS within the male population, as IC/BPS has traditionally been considered a disease of women. Thus, prevalence data varies widely. Diagnosis of IC/BPS in men is fraught with difficulty, as there is much overlap with other chronic pelvic pain syndrome, specifically chronic prostatitis. Key clinical features specific to IC/BPS are pain with bladder filling and relief with voiding. Painful ejaculation may be indicative of pelvic floor dysfunction. Physical exam, including extensive pelvic exam with analysis of pelvic floor tenderness, is critical in correct diagnosis. Ultrasound +/- urodynamics may be used to rule out obstructive disease, and urinalysis +/- culture must be used to rule out infection. There are no treatments specific to men with IC/BPS.</p><p><strong>Conclusions: </strong>We have described the prevalence, clinical characteristics, evaluation, and treatment of IC/BPS in men. There is a significant need for more sex-specific research of IC/BPS with consideration for hormonal and anatomical factors that may differentiate the disease in men.</p><p><strong>Clinical trial registration: </strong>No new data were generated for this manuscript; no clinical trial was conducted.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Review of the Etiopathology of Phenotypes in Interstitial Cystitis/Bladder Pain Syndrome.","authors":"Maxwell L Sandberg, Laura Santurri, David Klumpp, Larissa V Rodriguez, Daniel Clauw, Henry Lai","doi":"10.1002/nau.70097","DOIUrl":"https://doi.org/10.1002/nau.70097","url":null,"abstract":"<p><strong>Aims: </strong>The aim of this manuscript was to provide a narrative review of the etiopathology of three different interstitial cystitis/bladder pain syndrome (IC/BPS) phenotypes: Hunner lesion, widespread pain, and low bladder capacity.</p><p><strong>Methods: </strong>IC/BPS literature was reviewed by the authors specific to the three phenotypes, focusing on etiopathology. Evidence was condensed and summarized on the different causes of each phenotype, emphasizing papers and abstracts dealing with basic science research, symptoms, and treatment options for patients afflicted with the three different IC/BPS phenotypes.</p><p><strong>Results: </strong>Hunner lesion patients are marked by a distinct, visible inflammatory lesion in the bladder, inflammatory serum and urinary biomarkers, and respond well to bladder-centric treatments targeted specifically at the Hunner lesions. Widespread pain patients have diffuse pain attributed to central nervous system changes manifesting in the bladder, often with co-occurring non-bladder chronic pain conditions such as fibromyalgia and seem to respond better to systemic therapies. Low bladder capacity patients have a marked decrease in anesthetic bladder capacity during therapeutic hydrodistension of the bladder. They also tend to have higher pain scores, symptoms specifically concentrated at the bladder, and respond to localized treatments, constituting another bladder centric phenotype.</p><p><strong>Conclusions: </strong>IC/BPS should not be thought to represent one unique type or pathophysiology, but rather a diverse group of patients, each with their own etiopathology and phenotypic manifestations.</p><p><strong>Clinical trial registration: </strong>This was a narrative review and did not involve any direct intervention on patients nor direct patient contact and was not a clinical trial.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Gynecologic Findings in Interstitial Cystitis/Bladder Pain Syndrome: A Consensus.","authors":"Marie E Sullivan, Amr El Haraki, Anna Padoa, Katy Vincent, Kristene E Whitmore, Mauro Cervigni","doi":"10.1002/nau.70099","DOIUrl":"https://doi.org/10.1002/nau.70099","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the role of gynecologic findings in Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) by reviewing current international guidelines and identifying relevant gynecologic co-morbidities.</p><p><strong>Methods: </strong>This consensus statement was developed through a systematic four-phase process: (1) comprehensive literature review across PubMed/MEDLINE, Embase, Cochrane Library, and Web of Science databases (inception-January 2025) using predefined search terms related to IC/BPS and gynecologic conditions; (2) assembly of a 6-member multidisciplinary expert panel including urologists, urogynecologists, gynecologists and pain specialists; (3) consensus development via modified Delphi technique comprising several electronic rating rounds and a face-to-face meeting, with consensus defined as ≥ 80% agreement; and (4) manuscript preparation with iterative review.</p><p><strong>Results: </strong>A number of associated gynecologic disorders may overlap with IC/BPS, our consensus committee identified five main co-morbid disorders: Endometriosis/Adenomyosis, Genito-Pelvic Pain Penetration Disorder/Sexual Dysfunction, Overactive Pelvic Floor Muscles, Hormone- Associated Genitourinary Changes, Vulvodynia/Vestibulodynia.</p><p><strong>Conclusion: </strong>While not exhaustive, this consensus highlights the most prevalent gynecologic co-morbidities supported by current literature. Clinical evaluation should prioritize a detailed medical history and pelvic examination to identify these overlapping conditions. Future directions include developing a multidisciplinary diagnostic and treatment algorithm to guide clinicians-including urologists, gynecologists, urogynecologists, physical therapists-in comprehensive IC/BPS care.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interstitial Cystitis/Bladder Pain Syndrome Patient Phenotyping.","authors":"Dylan T Wolff, Stephen Tranchina, Andrew Schrepf, R Christopher Doiron, Toby C Chai, Stephen J Walker","doi":"10.1002/nau.70098","DOIUrl":"https://doi.org/10.1002/nau.70098","url":null,"abstract":"<p><strong>Aims: </strong>In April of 2025, the Wake Forest Institute for Regenerative Medicine hosted a Global Consensus meeting on IC/BPS in Winston-Salem, NC. The goal of this meeting was to establish global consensus regarding diagnostic criteria, phenotyping, treatment outcome assessment, and etiopathology in interstitial cystitis/bladder pain syndrome (IC/BPS). Our sub-committee was tasked with developing a consensus document on patient phenotyping in IC/BPS.</p><p><strong>Methods: </strong>Narrative review.</p><p><strong>Results: </strong>Patients with IC/BPS populate broad groups that have been characterized as having a bladder-focused disease phenotype (bladder-centric), a widespread pain and symptoms phenotype (systemic), or by other variable phenotypes including those with myofascial pelvic pain. In this review, we discuss the published evidence supporting each of these patient phenotypic groups.</p><p><strong>Conclusions: </strong>Future clinical trials and treatment development in IC/BPS should include patient phenotyping efforts with, at minimum, a focus on stratification into bladder-centric vs systemic and efforts to refine discriminative thresholds (cut-off points) that may influence differential treatment outcomes. It is important to continue to investigate the importance of patient phenotypes on treatment strategy selection, outcomes, and our understanding of the underlying pathophysiology for this disease spectrum.</p><p><strong>Clinical trial registration: </strong>N/A.</p>","PeriodicalId":19200,"journal":{"name":"Neurourology and Urodynamics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}