Therapeutic Strategies for a Narrative Review With Emphasis on Intravesical, Procedural and Regenerative Approaches Bladder Pain Syndrome

ABSTRACT

Bladder pain syndrome (BPS) is a chronic, heterogeneous condition impair patients' quality of life. expanding body of clinical evidence clinical decision‐making is by variability in patient phenotypes, endpoints, and follow‐up. significantlyingWhilst there is anin relation to potential treatment options, often hindered study inconsistencies. This narrative review explores current clinical evidence from randomised trials and early‐phase studies on treatment options key outcomes and results focusing. Studies intobehavioural interventions, dietary modifications and pelvic‐floor physiotherapy have consistently reported symptom relief in this patient cohort. Several intravesical agents in randomied studies (DMSO/KRP‐116Dintravesical interferon). atients with Hunner lesions, lesion‐directed procedures fulguration ± hydrodistention Botulinum toxin provides short‐term symptom improvementincreased risk of urinary retention. have shown symptom improvement seg: Preport clinically meaningful symptom relief with for example, whilst, albeit with an associated Regenerative strategies such as mesenchymal stem cells, PBMC injections, and ESWT show early promise small, single‐centre series with limited long‐term safety and durability data. Additionally, however, to date, these studiesare. The current evidence base is limited by small sample sizes, heterogeneous diagnostic criteria and phenotyping, inconsistent endpoints and timing, and underreporting of long‐term safety for regenerative interventions. There is a need for larger, multicentre trials with standardised phenotyping. Also, harmonised outcome evaluations and extended follow‐up duration are required to confirm efficacy and safety. Meanwhile, phenotype‐guided, multimodal care that combines targeted procedures or intravesical therapy with behavioural and pelvic‐floor approaches represents the most applied clinical strategy.