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Men with IC/BPS Present a Particular Challenge for Effective Treatment

Arora HC, Shoskes DA. The enigma of men with interstitial cystitis/bladder pain syndrome. Transl Androl Urol. 2015 Dec;4(6):668-76. doi: 10.3978/j.issn.2223-4683.2015.10.01.

This educational article makes the point that interstitial cystitis/bladder pain syndrome (IC/BPS) is a disorder that is common in men, yet frequently misdiagnosed. Previously, IC/BPS was thought to be rare in men, but by some recent estimates, up to 20% of IC/BPS patients are male. Men may experience the hallmark symptoms of IC/BPS, such as chronic discomfort and irritative voiding symptoms, yet may be told they have another condition, such as prostatitis, epididymitis (inflammation of a tube behind the testicle), or benign prostatic hyperplasia, or BPH. The delay in diagnosis that men experience in these situations means that they aren’t promptly receiving treatments that could ameliorate the symptoms of their IC/BPS. Even when IC/BPS is properly diagnosed, picking a potentially helpful treatment is challenging, since most studies haven’t incorporated many male patients. In clinical practice, there are many men with properly diagnosed IC/BPS who do benefit from IC/BPS specific treatments such as intravesical therapy, cyclosporine, and fulguration of ulcers. The authors recommend customizing treatment choices based on each male patient’s symptoms using the UPOINT system, and call for further research specifically in men with IC/BPS.