742 - Interstitial cystitis / Bladder pain syndrome : A case report : Diagnosis and Management

Case Diagnosis: We report the case of a 44-year-old patient admitted to our department of physical medicine and rehabilitation (PMR) for management of interstitial cystitis / bladder pain syndrome(IC/BPS) evolving for 2 years. She was being treated for the sequelae of rheumatoid arthritis on methotrexate at 30 years.

Case Description: The patient described persistent chronic pelvic pain with dyspareunia. She is also bothered by pollakiuria and urgenturia impairing quality of life. The physical examination was without anomalies, particularly the neurological examination. An inflammatory, renal and urinary (negative cytobacteriological exam of urine) biologic workup was performed with no abnormalities. A renal ultrasound was performed and
was normal. As these investigations were normal, a urodynamic study revealed bladder pain on filling, an early painful first sensation to void with a maximal cystometric capacity of 300 ml . The diagnosis of IC/BPC was suspected and the patient was referred to a urologist where the diagnosis was confirmed after cystoscopy and bladder biopsy.
To relieve her pain, we opted for acupuncture once a week, as well as antidepressants, which
improved both her pain and her urgency

Discussions: IC/BPS is a chronic condition with highly prevalent negative consequences on quality of life
which is characterized by chronic voiding dysfunction including pain, urgency, and
frequency. It is often underdiagnosed and mistreated. The difficulties in diagnosis stem from
numerous theories regarding pathophysiology and etiology.Moreover it remains a diagnosis of
elimination, based on a series of tests designed to rule out other pathologies.
However, there is a lack of consensus regarding treatment options that improve pain in this
population.

Conclusions: IC/BPC is still a rare diagnosis. Recognition is essential to reduce diagnostic latency and limit our patients'suffering.
PMR can offer therapeutic alternatives to relieve our patients and improve their quality of life.