The Biology of Irritative Bladder Symptoms: Urine Microbiota, Cytokine Profiles and Symptom Severity Among Women with Interstitial Cystitis/Painful Bladder Syndrome

Interstitial Cystitis/Painful Bladder Syndrome (IC/PBS) is chronic pelvic pain characterized as perceived pain in the lower abdomen and pelvis of women for more than six months and is a particularly debilitating disorder with severe disease burden (3). The presentation of symptoms can be quite variable among patients, suggesting that IC/PBS is a multi-factorial disease with several proposed etiologies, some of which may be interrelated. Painful Bladder Syndrome (PBS), as defined by the International Continence Society, is “the complaint of suprapubic pain related to bladder filling, accompanied by other symptoms, such as increased daytime and night-time frequency, in the absence of proven urinary infection or other obvious pathology” (4). PBS is a clinical description of disease based on the patient’s symptoms and does not depend on urodynamic or cystoscopic findings and diagnostic criteria are still lacking for this entity. Estimates of prevalence of the urologic pelvic pain syndromes vary widely. Approximately, 3.3 to 7.9 million United States women 18 years old or older were found to have bladder pain syndrome/interstitial cystitis symptoms in a population-based study published in 2011 (5). Quality of life with IC/PBS is significantly reduced particularly in those with other concomitant chronic conditions like fibromyalgia and irritable bowel syndrome (6).