Treatment of bladder pain syndrome and interstitial cystitis: a systematic review

Int Urogynecol J. 2016 May;27(5):697-708. doi: 10.1007/s00192-015-2815-5. Epub 2015 Aug 14.

Abstract

Introduction and hypothesis: Bladder pain syndrome/interstitial cystitis (BPS/IC) has various treatments; however, no standardized treatment has been established. The aim was to analyze different types of treatment of BPS/IC and their effectiveness.

Methods: A literature review with a search strategy for articles related to BPS/IC published between 1990 and 2014 was conducted on MEDLINE, PUBMED, and SCOPUS. Only randomized controlled trials in women were included in the meta-analysis, while other experimental studies were used as bases for a systematic review of the topic. Clinical trial quality was defined according to the Jadad scale.

Results: Of 356 articles, 13 were included in the analysis. The intervention methods were as follows: instillation of hyaluronic acid, botulinum toxin A, intravesical lidocaine, hyperbaric chamber, massage, physiotherapy, phosphate-buffered saline, piroxicam in combination with doxepin, and others. We did not find any treatment with at least two randomized controlled trials for meta-analysis. Among the assessment tools for symptoms of BPS/IC, the most frequently used were the visual analogue scale, voiding record, and the O'Leary-Sant questionnaire.

Conclusion: Existing studies were not able to define the best approach for the treatment of BPS/IC. The lack of standardized treatment may be related to the diversity of interventions used; therefore, further studies with better methodological quality are needed.

Keywords: Bladder pain syndrome; Drug treatment; Interstitial cystitis; Prospective and clinical trials.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Acetylcholine Release Inhibitors / administration & dosage
  • Adjuvants, Immunologic / administration & dosage*
  • Administration, Intravesical
  • Anesthetics, Local / administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Antidepressive Agents / therapeutic use
  • Botulinum Toxins, Type A / administration & dosage
  • Cystitis, Interstitial / therapy*
  • Drug Therapy, Combination
  • Female
  • Humans
  • Hyaluronic Acid / administration & dosage*
  • Hyperbaric Oxygenation
  • Lidocaine / administration & dosage
  • Pentosan Sulfuric Polyester / administration & dosage
  • Physical Therapy Modalities
  • Sodium Chloride / administration & dosage

Substances

  • Acetylcholine Release Inhibitors
  • Adjuvants, Immunologic
  • Anesthetics, Local
  • Anti-Inflammatory Agents, Non-Steroidal
  • Antidepressive Agents
  • Pentosan Sulfuric Polyester
  • Sodium Chloride
  • Hyaluronic Acid
  • Lidocaine
  • Botulinum Toxins, Type A