To explore the characteristics, diagnosis, and treatment of four cases of bladder cancer presenting as interstitial cystitis/bladder pain syndrome (IC/BPS) to improve the diagnosis and treatment efficiency of bladder cancer in men with IC/BPS.

Male patients with interstitial cystitis who were admitted to the Department of Urology of Peking University First Hospital for random biopsy and water dilatation from January 2015 to January 2018 were reviewed. Relevant clinical data and follow-up data were collected. Main symptoms, duration of symptoms, microscopic manifestations of water dilatation, postoperative pathology, reoperation method, and follow-up information were summarized.

Four cases were confirmed as bladder cancer by pathology and were included in this study. The patients were aged 53, 46, 71, and 67, respectively. One of the patients had previously undergone holmium laser enucleation of the prostate. The pathologies were papillary transitional cell carcinoma, high-grade urothelial carcinoma, high-grade urothelial carcinoma, and papillary transitional cell carcinoma, respectively. The maximum preoperative free urine volume was 155, 18, 75, and 93 ml, respectively, and the bladder capacity after water dilatation was 400, 95, 140, and 250 ml, respectively. The bladder showed a pale mucosa, extensive punctate hemorrhage, and local fibrinous exudation during water dilation. Cases 1 and 4 showed redness and thickening of local mucosa and follicular changes. All the 4 patients finally received total bladder resection, and the pain symptoms were relieved in all. No recurrence was detected.

Men with IC/BPS need to be alert to the presence of bladder cancer, and multiple, repeated random biopsies are recommended, which may improve the diagnosis rate of bladder cancer.