Endometriosis and Interstitial Cystitis/Bladder Pain Syndrome: A Systematic Review of Prevalence, Urinary Symptoms, and Overlapping Pelvic Pain Syndromes

Authors

Hanoof Alqhatani¹, Marwa Abdulaziz Alahmadi², Malak Hamed Ajlan Alshammari³, Fadiyah Abdullah Obaid Alharbi⁴, Atheer nasser mohamed alhrany⁵, Khalid Mohammed Alqahtani⁶, Mashael abdullah abdalrahman alqahtani⁷, Manal Saeed Mohammed Al-Qahtani⁸, Bushra Ali Saleh Al Ghamdi⁹, Rasis Khalid Saleh Saber¹⁰, Malak Mohammed Ayedh Alhajri¹¹, Salem Hisham Salem Jobah¹².

Keywords

Endometriosis; Interstitial Cystitis; Bladder Pain Syndrome; Chronic Pelvic Pain; Urinary Symptoms; Dysuria

Abstract

Background: Endometriosis (10–15% of reproductive-aged women) and Interstitial Cystitis/Bladder Pain Syndrome
(IC/BPS; 2.3–6.5%) frequently coexist (15.5–78.3%) in women with chronic pelvic pain, yet overlapping symptoms often
delay diagnosis and result in treatment failure.
Objective: This systematic review synthesizes evidence on the association between endometriosis and IC/BPS, focusing
on prevalence, urinary symptoms, and overlapping pelvic pain syndromes.
Methods: A comprehensive literature search was conducted across PubMed, Embase, and the Cochrane Library (last five
years) following PRISMA guidelines. Studies reporting original data on urinary symptoms or IC/BPS in endometriosis
patients were included. Five studies (575 participants) were assessed using JBI critical appraisal tools.
Results: Urinary symptoms (dysuria) prevalence ranged from 22% (adolescents) to 50% (adults). Painful bladder syndrome
was associated with poor sleep in 94% of affected women (p < 0.01). Deep infiltrating endometriosis showed significantly
higher dysuria/dyschezia rates (p < 0.001), correlating with #ENZIAN compartments (p < 0.05). Overlapping visceral pain
syndromes affected 74.2% of women with CPP. Symptoms improved with conservative therapy (p < 0.001) and anti
inflammatory approaches.
Conclusions: Endometriosis and IC/BPS frequently coexist, with a 3.74-fold increased risk of IC/BPS. Shared central
sensitization and cross-organ mechanisms warrant multidisciplinary care. Routine IC/BPS screening in endometriosis
patients with persistent pain is essential.

Author Information

1.
Obstetrics and Gynaecology Assistant Professor, King Khalid University · Abha, Saudi Arabia
Email: Beutifulsmile1409@hotmail.com
2.
Senior Registrar in Riyadh Hospital, Saudi Arabia Email: marwa.alahmadi95@gmail.com
3.
Obstetric and Gynecology Resident, King Fahad Medical City, Riyadh, Saudi Arabia,
Email: malak.ha.alshammari@gmail.com
4.
Obstetric and Gynecology Resident, Maternity and Children's Hospital (MOH/Qassim Cluster), Buraidah, Qassim, Saudi
Arabia, Email: Fadiyahabdul@gmail.com
5.
Obstetric and Gynecology Resident, Abha Maternity and Children's Hospital (MOH), Abha, Saudi Arabia,
Email: matheer492@gmail.com
6.
7.
Obgyn Resident, Abha Maternity and Children's Hospital, Abha, Saudi Arabia, Email: kmfare@windowslive.com
Obstetric and Gynecology Resident, Abha Maternity and Children's Hospital (MOH), Abha, Saudi Arabia,
Email: meesho.1415@hotmail.com
8.
Resident Obstetrics and Gynecology, King Faisal Armed Forces Hospital in the South, Khamis Mushait, Saudi Arabia,
Email: manal.15345@hotmail.com
9.
10.
King Faisal Medical Complex (MOH), Taif, Saudi Arabia, Email: bushraali96@outlook.sa
Obstetrics and Gynecology Resident, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia,
Email: Raseess.sa@gmail.com
11.
Obstetric and Gynecology Resident, Saudi German Hospital (Private), Abha, Saudi Arabia,
Email: Dr_malak1996@hotmail.com
12.
Obstetric and Gynecology Resident, Makkah Maternity and Children's Hospital (MOH), Makkah, Saudi Arabia,
Email: dr.shj1990@gmail.com
Corresponding author: Marwa Abdulaziz Alahmadi Email: marwa.alahmadi95@gmail.com

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