Editorial Comment on "Gynecologic Manifestations of Interstitial Cystitis/Bladder Pain Syndrome" by K. E. Whitmore and J. Pires.

The author declares no conflicts of interest.

This is a comprehensive review of what is known about BPS/IC gynecologic influences, related symptoms and signs. Following the actual guidelines clear gynecologic causes of Chronic Pelvic Pain are to be discarded from the BPS/IC Syndrome as confusable diseases [ 1 ]. On the contrary are gynecologic comorbidities present in a high number of BPS/IC patients where both syndromes are responsible for symptoms. Endometriosis, vulvodynia/vulvar pain syndrome are discussed. Other conditions as a high pelvic tone of the pelvic floor (high tone pelvic floor dysfunction HTPFD), pudendal neuralgia (PN) and dyspareunia form a mixed group that can occur with pathology of different pelvic structures and organs or on their own. The report in patients who have BPS/IC and see the symptoms disappear when they become pregnant point also to the important influence of estrogens. Diagnostic methods are given for CPP: These are extended but in experienced hands not too time consuming. Treatment will use methods developed for BPS/IC and add symptomatic treatment of gynecologic conditions. In principle treatment should start with conservative measures including rules of good behavior and self‐care. Ample importance should be given to psychological support. When these treatments fail to bring relieve, more invasive methods are available. It is important to discuss all with the patient beforehand, in detail. It is extremely important to present the possible results of the BPS/IC treatments: what can be promised and what not. There is no cure available for the BPS/IC condition today related to the absence of knowledge about causes. Trying to improve all symptoms should be the goal. This involves in many a multimodal treatment and involvement of different specialties. It remains a difficult but fascinating clinical entity for the physician and a devastating experience for the patient which needs attentive and supportive care.