Definition and Classification of Bladder Pain Syndrome
Definition. The most commonly used definition of Bladder Pain Syndrome is the one proposed by the Society of Urodynamics and Female Urology (SUFU) which refers to it as “an unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms of more than six weeks duration, in the absence of infection or other identifiable causes” (Hanno, Philip & Dmochowski 2009). In 2011, this definition was adopted by the American Urology Association (AUA) and continues to be used to this day.
Currently bladder pain syndrome is diagnosed exclusively on the basis of reported symptoms, though medical tests are used to rule out the possibility of other medical conditions and causes.
Classification. The classification of bladder pain is more complex and characterised by an inability of major associations to arrive at a common consensus. Today, a mix of terms continues to be used in publications and consumer representative groups, including interstitial cystitis (IC), painful bladder syndrome (PBS), bladder pain syndrome (BPS) and chronic pelvic pain syndrome (CPPS). The term IC is more widely accepted as differentiating a subgroup of BPS characterised by some bladder pathology in the form of glomerulations and Hunners’ lesions. Generally BPS is the preferred term for bladder pain diagnosed on the basis of exclusion, in which there is a lack of end-organ pathology. However, the lack of organ pathology does not necessarily exclude functional changes in the end organ, for which the physiological mechanisms are still poorly understood.