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The diagnosis of bladder pain syndrome/interstitial cystitis (BPS/IC) is substantially clinical, according to the ESSIC definition. After clinical suspicion, it is mandatory to exclude confusable diseases and identify phenotypical aspects of the disease. There are different severity grades, involved organs, possible allergies, and impact on quality of life. Some of these aspects can vary in the natural history of disease as well as after treatment. To facilitate a diagnostic pathway and follow-up, we suggest a standardized system. We elaborated a chart with 12 items, each considering a peculiar aspect/domain of the disease: micturition diary, Visual Analogue Scale (VAS), presence of pelvic/systemic pain, symptom prevalence (pain/LUTS), validated questionnaires, associated pathologies, allergies and intolerances, ESSIC classification, bladder anatomical capacity, and pelvic floor involvement. The grid is proposed to be a simple and immediate instrument to characterize the clinical picture and follow the variations over time.

ProACT is an extra urethral bulking system made of a silicone balloon connected with a dual lumen tubing (12–14 cm) to a titanium scrotal port that allows the postoperative adjustment (Fig. 6.1). It was introduced in the European market in 2000 as the first non-circumferential compressive device. The continence mechanism is guaranteed by a bilateral compression of the urethra, augmenting maximum urethral closure pressure (MUCP). In a study by Reuvers et al. this mechanism was demonstrated in a cohort of 23 successfully implanted patients in which a significant increase in MUCP from 58 cmH2O to 79 cmH2O was observed [1].

Urinary incontinence (UI) is a “storage symptom.” The most recommended definition of incontinence in men, as well as in women, is that of the fifth International Consultation on Incontinence (ICS): “the complaint of any involuntary loss of urine” [1]. This definition is suitable for epidemiological studies of male incontinence, but in clinical practice it must be emphasized that: the loss of urine should be objectively demonstrable, it should happen in socially unaccepted time and place (“social or hygienic problem”), and it should be expelled from an orthotopic anatomically intact urinary system (e.g., urinary leakage from a ureteroileocutaneous urinary diversion is not considered a form of incontinence).