Background
While IC/BPS is predominantly diagnosed in
women, male patients with similar symptoms are often misclassified under
chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), leading to delays
in diagnosis and suboptimal treatment. This study aims to compare the
demographic, clinical, and treatment response profiles of male versus female
IC/BPS patients.
Methods
A retrospective analysis of 180 IC/BPS
patients (60 males, 120 females) was conducted at a tertiary urology center
over 4 years. Inclusion was based on AUA criteria for IC/BPS. Data on symptom
duration, diagnostic delay, symptom severity (VAS, ICSI/ICPI), prior diagnoses,
cystoscopic findings, and treatment responses were compared.
Results
- Delayed Diagnosis: Male patients had a
significantly longer diagnostic delay (mean 28.4 months vs. 14.7 months;
p<0.001).
- Symptom Profile: Men presented more frequently with voiding symptoms (67% vs.
39%; p=0.002) and less with suprapubic pain.
- Misdiagnosis: 72% of male patients had previously been diagnosed with CP/CPPS
and received antibiotics or alpha-blockers without improvement.
- Cystoscopy: Hunner lesions were equally prevalent (32% in males vs. 29% in
females; p=0.65), refuting assumptions of different disease phenotypes.
- Treatment Outcomes: Male patients responded comparably to standard IC/BPS
therapies once diagnosed correctly, though their initial symptom severity was
higher.
Conclusion
Men with IC/BPS represent a clinically
distinct and often overlooked subgroup. Diagnostic delays and misclassification
contribute to unnecessary morbidity. Increasing awareness and refining
diagnostic algorithms for men with chronic pelvic pain can enable earlier
intervention and better outcomes.