Review on chronic pelvic pain from a urological point of view

Chronic pelvic pain or interstitial cystitis (IC) is an enigmatic and frustrating condition to manage as physician and to cope with as patient. Patients report moderate to excruciating pain in the suprapubic and/or vaginal area, urgency and frequency (up to 50 micturitions per day), and disruption of their social life. Many patients are declared as drug addicted and neurotic. Social status and the number of sexual partners showed no correlation with incidence. Diagnosis of IC is made by exclusion. A number of pathophysiologic mechanisms have been proposed: changes in epithelial permeability, pelvic floor dysfunction, mastocytosis, activation of C-fibers, increase of nerve growth factors, and bradykinin. No single theory can explain IC.