Objective: To provide an updated clinical framework for the definition,diagnosis and treatment of bladder pain syndrome/interstitial cystitis(BPS/IC)according to the current available best evidence and advises a multimodal approach in its management.Methods: A systematic literature review using the MEDLINE(@)database(search dates 01/01/1975-07/04/2015)was conducted to identify peer-reviewed publications relevant to the aetiology,diagnosis and treatment of IC/BPS using "interstfial cystitis" or "bladder pain syndrome" as the keywords.Results: A slightly modified definition of BPS/IC was developed by the International Consultation on Incontinence [2010]: an unpleasant sensation(pain,pressure,discomfort)perceived to be related to the urinary bladder,associated with lower urinary tract symptom(s)of more than 6 weeks duration,in the absence of infection or other identifiable causes.Although this widely accepted definition expands the patient population,the condition is still regarded as a diagnosis of exclusion.There have been no significant conclusive advances made in understanding either the etiology or pathogenesis of BPS/IC.Central neurological pathogenesis,genetic/familial,immunological,and infectious etiologies may be responsible for this puzzling and complex disorder.Patient education,self-care(diet modification)and stress management remain to be the first-line treatments.Intradetrusor botulinum toxin A injection,which was paired with cyclosporine as a fifth-line therapy in the initial guideline,was moved to a fourth-line therapy against BPS/IC based on the latest AUA guidelines.Intravesical DMSO/DMSO cocktail for BPS/IC patients is reported to be associated with 65-90%response rates.Significant improvements in the mean VAS score,urinary urgency and bladder capacity are noted in BPS/IC patients receiving intravesical DMSO/DMSO cocktail treatment,although the long term effectiveness still needs to be evaluated.Conclusions: As the science relevant to BPS/IC evolves and improves,the strategies presented will require amendment to remain consistent with the highest standards of care.The consideration of BPS/IC as a part of a generalized somatic disorder should open new pathways to the study of BPS/IC.