Pathophysiology of interstitial cystitis

Despite being described over 80 years ago, interstitial cystitis remains a disease of undetermined aetiology and poor treatment outcomes. Generally ag reed diagnostic criteria of this condition, which occurs primarily in femal es, are frequency, urgency and pain, a low-capacity hypersensitive bladder, and mucosal haemorrhages and tearing on bladder distention. Although curre nt theories of pathophysiology are predominantly conjecture, important elem ents of the disease process are increased afferent and efferent neuronal ac tivity, an excess of inflammatory mediators, increased epithelial permeabil ity and possibly reduced bladder vascularity. Improved treatment outcome wi ll follow a better understanding of pathophysiology. (C) 2000 Lippincott Wi lliams & Wilkins.