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Review
. 2024 Nov 29;12(23):2403.
doi: 10.3390/healthcare12232403.

The Evil Twins of Chronic Pelvic Pain Syndrome: A Systematic Review and Meta-Analysis on Interstitial Cystitis/Painful Bladder Syndrome and Endometriosis

Alessandra Inzoli  1 , Marta Barba  2 , Clarissa Costa  1 , Valeria Carazita  1 , Alice Cola  2 , Martina Fantauzzi  2 , Paolo Passoni  2 , Serena Polizzi  2 , Matteo Frigerio  2
Affiliations
Review

The Evil Twins of Chronic Pelvic Pain Syndrome: A Systematic Review and Meta-Analysis on Interstitial Cystitis/Painful Bladder Syndrome and Endometriosis

Alessandra Inzoli et al. Healthcare (Basel). .

Abstract

Background: Chronic pelvic pain is a debilitating condition affecting quality of life. Endometriosis is one of the leading causes of CPP, but recent studies highlighted the role of interstitial cystitis/bladder pain syndrome (IC/PBS) in causing CPP. Only some studies addressed the coexistence of these two conditions, which seems more frequent than what is supposed, leading to diagnostic delays and unnecessary surgeries. This systematic review aimed to evaluate the estimate of the prevalence of the comorbidity of endometriosis and IC/PBS.

Methods: We performed a systematic review of the literature indexed on PubMed, Scopus, ISI Web of Science, and Cochrane using a combination of keywords and text words represented by "painful bladder syndrome", "endometriosis", "interstitial cystitis", and "bladder pain syndrome". We performed a meta-analysis of the results.

Results: The meta-analysis shows that the coexistence of endometriosis and IC/PBS in women with CPP ranged from 15.5% to 78.3%, which is higher than the prevalence of IC/PBS in the general population.

Conclusions: Prevalence data about the coexistence of endometriosis and IC/PBS are highly heterogeneous, probably due to the paucity of available data. However, in cases of endometriosis unresponsive to treatment, other reasons for CPP (such as IC/PBS) need to be ruled out.

Keywords: chronic pelvic pain; endometriosis; interstitial cystitis/bladder pain syndrome.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Search strategy according to PRISMA 2020 [30].
Figure 2
Figure 2
Meta-analysis of included studies (events means the presence of IC/PBS) [31,34,39,40].
Figure 3
Figure 3
The “Evil Twins Syndrome” (created with BioRender.com).
See this image and copyright information in PMC

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