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A guideline from the American Urological Association defines interstitial cystitis/bladder pain syndrome (IC/BPS) as “an unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms of more than six weeks duration, in the absence of infection or other identifiable causes.” Pentosan polysulfate sodium (PPS; Elmiron) is FDA-approved for treating patients with interstitial cystitis, but the few small randomized trials of its efficacy have not been uniformly positive (NEJM JW Gen Med Nov 1 2003 and J Urol 2003; 170:810). According to the manufacturer, the mechanism of action is not understood completely, but the drug is thought to protect bladder mucosa from irrit…