A prospective surgical evaluation of the coexistence of endometriosis and interstitial cystitis/bladder pain syndrome

Giovanni Favero, Favero G, Felix Zeppernick, Zeppernick F, Zeppernick M, Magdalena Zeppernick, Pfiffer T, Tatiana Pfiffer, Schwandner T, Thilo Schwandner, Meinhold-Heerlein I, Ivo Meinhold-Heerlein
Archives of gynecology and obstetrics · 2026 · vol. 313(1) · doi:10.1007/s00404-026-08507-y · PMID:42414622 · PMC13346136 · W7167594138
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Abstract

BACKGROUND: Endometriosis and interstitial cystitis/bladder pain syndrome (IC/BPS) frequently coexist; however, diagnostic delays and non-standardized criteria limit accurate identification of these conditions. OBJECTIVE: To assess the feasibility, safety, and clinical characterization of coexisting endometriosis and IC/BPS using a standardized surgical evaluation approach. METHODS: In this prospective single-center study, approximately 100 women with presumed endometriosis and bladder symptoms undergoing laparoscopy for staging and/or treatment will simultaneously undergo diagnostic cystoscopy for IC/BPS. Optical confirmation and phenotype characterization of IC/BPS will be assessed. In cases with cystoscopic signs of IC/BPS, a standardized therapeutic protocol will be initiated to address bladder-centric symptoms alongside endometriosis treatment. RESULTS: The study will evaluate whether systematic surgical assessment enables reliable detection of coexisting endometriosis and IC/BPS and facilitates the identification of bladder-centric and non-bladder-centric IC/BPS phenotypes. Early recognition of IC/BPS in women with endometriosis may reduce unnecessary interventions and inform individualized management strategies. DISCUSSION: The combination of standardized laparoscopy and cystoscopy may improve diagnostic precision in patients with suspected coexisting endometriosis and IC/BPS. The study is expected to provide insights that support phenotype-driven, multidisciplinary care and inform future research and the development of integrated diagnostic algorithms.

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MeSH descriptors

Cystitis, Interstitial Cystitis, Interstitial Cystitis, Interstitial Cystitis, Interstitial Cystitis, Interstitial Cystitis, Interstitial Cystitis, Interstitial Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Adult Adult Adult Adult Cystoscopy Cystoscopy

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