A prospective surgical evaluation of the coexistence of endometriosis and interstitial cystitis/bladder pain syndrome

Background Endometriosis and interstitial cystitis/bladder pain syndrome (IC/BPS) frequently coexist; however, diagnostic delays and non-standardized criteria limit accurate identification of these conditions. Objective To assess the feasibility, safety, and clinical characterization of coexisting endometriosis and IC/BPS using a standardized surgical evaluation approach. Methods In this prospective single-center study, approximately 100 women with presumed endometriosis and bladder symptoms undergoing laparoscopy for staging and/or treatment will simultaneously undergo diagnostic cystoscopy for IC/BPS. Optical confirmation and phenotype characterization of IC/BPS will be assessed. In cases with cystoscopic signs of IC/BPS, a standardized therapeutic protocol will be initiated to address bladder-centric symptoms alongside endometriosis treatment. Results The study will evaluate whether systematic surgical assessment enables reliable detection of coexisting endometriosis and IC/BPS and facilitates the identification of bladder-centric and non–bladder-centric IC/BPS phenotypes. Early recognition of IC/BPS in women with endometriosis may reduce unnecessary interventions and inform individualized management strategies. Discussion The combination of standardized laparoscopy and cystoscopy may improve diagnostic precision in patients with suspected coexisting endometriosis and IC/BPS. The study is expected to provide insights that support phenotype-driven, multidisciplinary care and inform future research and the development of integrated diagnostic algorithms.