Chrysanthopoulou Eleftheria L, Doumouchtsis Stergios K
Department of Obstetrics and Gynaecology, St George's Healthcare NHS Trust/St George's University of London, London, United Kingdom.
Neurourol Urodyn. 2014 Nov;33(8):1193-201. doi: 10.1002/nau.22475. Epub 2013 Aug 14.
Bladder pain syndrome (BPS) is an enigmatic condition, which can be debilitating for the patients, affecting their quality of life. Its prevalence is believed to have become markedly higher (100-300/100,000 women) than in previous years. Its etiology and pathogenesis remain unknown, and a number of theories based on clinical and experimental observations have been developed. It is difficult to be diagnosed and treated. There is a worldwide effort to standardize its nomenclature, definition, diagnosis, and treatment algorithm. The aim of this review is to critically appraise the current evidence on the diagnosis and management of BPS.
We performed a review of the literature (Pubmed, Embase, Cochrane, Google Scholar, conference proceedings) as well as consensus statements and guidelines from relevant professional societies. We have critically compared these statements and guidelines with emphasis on the controversies.
Patients may experience pain and lower urinary tract symptoms for a long time before diagnosis, affecting their mental health and work, causing stress, sleep disturbance, depression, and sexual dysfunction. BPS has been considered as one of a group of chronic pain syndromes rather than as primarily an inflammatory bladder disorder. Despite the wide range of treatments, most are empirical and inadequate, usually offering just symptom relief. There is often delay in commencing treatment, and this may result in worse prognosis.
Efforts are focused on different pathways for the early identification of this syndrome, trying to elucidate the pathogenetic mechanism, as well as introducing effective treatments.
膀胱疼痛综合征（BPS）是一种神秘的病症，会使患者衰弱，影响其生活质量。据信其患病率已显著高于往年（每10万名女性中有100 - 300例）。其病因和发病机制尚不清楚，基于临床和实验观察已提出了一些理论。该病症难以诊断和治疗。全球正在努力规范其命名、定义、诊断和治疗方案。本综述的目的是批判性地评估当前关于BPS诊断和管理的证据。
我们对文献（PubMed、Embase、Cochrane、谷歌学术、会议论文集）以及相关专业协会的共识声明和指南进行了综述。我们对这些声明和指南进行了批判性比较，重点关注其中的争议点。
患者在确诊前可能长期经历疼痛和下尿路症状，影响其心理健康和工作，导致压力、睡眠障碍、抑郁和性功能障碍。BPS被认为是一组慢性疼痛综合征之一，而非主要是一种炎症性膀胱疾病。尽管有多种治疗方法，但大多数都是经验性的且不充分，通常只能缓解症状。治疗往往开始延迟，这可能导致预后更差。
工作重点在于通过不同途径早期识别该综合征，试图阐明发病机制，并引入有效的治疗方法。
