Table 1. Tiers of treatment for interstitial cystitis/bladder pain syndrome (IC/BPS).

First line treatments

General relaxation/stress management

Pain management

Patient education

Self-care/behavioral modification

Second line treatments

Manual physical therapy

Oral therapies

Intravesical therapies

Pain management

Third line treatments

Cystoscopy under anesthesia with hydrodistention

Pain management

Fulguration of Hunner’s lesions if found

Fourth line treatments

Intradetrusor botulinum toxin A

Neuromodulation

Pain management

Fifth line treatments

Cyclosporine A

Pain management

Sixth line treatments

Diverson with or without cystectomy

Pain management

Substitution cystoplasty