Interstitial Cystitis/Painful Bladder Syndrome (IC/PBS) is a complex syndrome characterized by chronic pelvic pain, urinary frequency and urgency, and impaired quality of life (1). Current guidelines recommend conservative approaches as the first-line treatment (2), and pelvic floor muscle training improves bladder control by reducing pain and symptoms, while dietary modifications are also effective in reducing symptom severity (3).
The aim of this study is to investigate the effects of elimination diet and pelvic floor muscle training on symptoms, problem perception, and movement imagery ability in individuals diagnosed with IC/PBS.

A total of 13 women diagnosed with IC/PBS by a urologist, with a mean age of 44.00±7.51 years, were included in the study. Data were collected using a demographic form; symptoms were evaluated using the Interstitial Cystitis Symptom Index (ICSI), and the impact on daily life was evaluated using the Interstitial Cystitis Problem Index (ICPI). Movement imagery ability was assessed using the Movement Imagery Questionnaire-3 (MIQ-3). Participants were divided into diet + training and diet groups; evaluations were performed before and after the intervention. The diet + training group received pelvic floor muscle training and an elimination diet, while the diet group received only an elimination diet. The diet + training group underwent treatment via online sessions twice weekly for 6 weeks, while the diet group received online treatment once weekly for 6 weeks. The study was conducted in accordance with the Declaration of Helsinki, and ethical approval and informed consent were obtained. Within-group analyses were performed using the Related-Samples Wilcoxon Signed Rank Test, and between-group analyses were performed using the Independent-Samples Mann Whitney U test.

In within-group analyses, a significant improvement was observed only in ICPI (p=0.026) in the diet group, whereas significant improvements were found in ICSI (p=0.033), ICPI (p=0.046), and kinesthetic imagery (p=0.018) in the diet + training group. Between-group analyses showed that no significant differences were found in ICSI (p=0.566) and ICPI (p=0.351), while significant differences were observed in internal visual imagery (p=0.031) and kinesthetic imagery (p=0.004). No significant difference was found between groups in external visual imagery (p=0.098).

Elimination diet combined with pelvic floor muscle training demonstrates a positive effect on problem perception and movement imagery abilities in patients with IC/PBS. These findings support the importance of multidisciplinary approaches.

The combination of pelvic floor muscle training and an elimination diet is an effective conservative approach for improving symptom perception and motor imagery in patients with IC/PBS.

Li, J., Yi, X., & Ai, J. (2022). Broaden Horizons: The Advancement of Interstitial Cystitis/Bladder Pain Syndrome. International Journal of Molecular Sciences, 23(23). https://doi.org/10.3390/ijms232314594
Clemens, J. Q., Erickson, D. R., Varela, N. P., & Lai, H. H. (2022). Diagnosis and Treatment of Interstitial Cystitis/Bladder Pain Syndrome. The Journal of Urology. (Philadelphia, PA). https://doi.org/10.1097/JU.0000000000002756
Kravchick, S., Shulman, D., Fitzgerald, J. G., Moldwin, R. M., Kavoussi, L. R., Parekattil, S. J., & Bratslavsky, G. (2026). A simplified algorithm for management of CP/CPPS and associated entities: A summary table for general urologists. Current urology, 20(2), 69–81. https://doi.org/10.1097/CU9.0000000000000320