Meta- analysis of RCTs showed that only cyclosporine A provided a simultaneous great effect size of SMD on ICSI , pain , and frequency .
Amitriptyline at different dosages showed a great effect size of SMD on pain and urgency or on ICSI and frequency .
The results from the n RCTs showed that the most frequently adopted treatment is oral pentosan polysulfate and that the use of botulinum A toxin intradetrusorial injections in PBS/IC is increasing .
Limited evidence exists for the few treatments for PBS/IC .
The lack of definitive conclusions is due to the great heterogeneity in methodology , symptoms assessment , duration of treatment , and follow-up in both RCTs and n RCTs
CONTEXT Different types of behavioural , dietary , interventional , pharmacologic , and surgical therapies have been used to treat painful bladder syndrome/interstitial cystitis ( PBS/IC ) .
Because of the paucity of r and omised placebo-controlled studies on different treatments , an evidence -based management approach has not yet been developed .
OBJECTIVE To critically review and synthesize data from a wide range of current therapeutic approaches to PBS/IC , to quantify the effect size from r and omised controlled trials ( RCTs ) , and to reach clinical agreement on the efficacy of treatments for PBS/IC .
A rational combination of intravesical and systemic agents for the treatment of interstitial cystitis
Objective . Interstitial cystitis is a condition with a poorly understood etiology and , consequently , various treatment options have been described in the literature , with a less than optimal outcome . The aim of this study was to examine the role of a combination of intravesical hydrocortisone and heparin , together with oral bladder sedatives and systemic triamcinolone , for the treatment of interstitial cystitis . Material and methods . A total of 26 patients who were diagnosed as having interstitial cystitis were treated with weekly intravesical hydrocortisone ( 200 mg ) and heparin ( 25 000 IU ) in physiological saline for 6 weeks . In addition , they were given oral bladder sedatives such as oxybutynin or tolterodine . Ulcerative , refractory and recurrent cases were treated with intramuscular triamcinolone ( 40 mg ) weekly for 6 weeks . Results . All patients experienced an improvement in symptoms within 48 h of their first intravesical instillation . While 19 patients ( 73 % ) experienced almost complete pain relief , five of the remaining seven patients improved with intramuscular triamcinolone .  Frequency reduced from a mean of 23.2 to 10.9 voids per day and was acceptable in 21 patients ( 80 % ) . Six patients ( 23 % ) had a relapse of symptoms in the form of pain and were treated satisfactorily by means of intramuscular triamcinolone . The mean duration of follow-up was 18.3 months . Conclusion . A combination of intravesical hydrocortisone and heparin , along with oral bladder sedatives and systemic steroids , has been used with encouraging results in a small group of patients with interstitial cystitis
Meta- analysis of RCTs showed that only cyclosporine A provided a simultaneous great effect size of SMD on ICSI , pain , and frequency .
Amitriptyline at different dosages showed a great effect size of SMD on pain and urgency or on ICSI and frequency .
The results from the n RCTs showed that the most frequently adopted treatment is oral pentosan polysulfate and that the use of botulinum A toxin intradetrusorial injections in PBS/IC is increasing .
Limited evidence exists for the few treatments for PBS/IC .
The lack of definitive conclusions is due to the great heterogeneity in methodology , symptoms assessment , duration of treatment , and follow-up in both RCTs and n RCTs
CONTEXT Different types of behavioural , dietary , interventional , pharmacologic , and surgical therapies have been used to treat painful bladder syndrome/interstitial cystitis ( PBS/IC ) .
Because of the paucity of r and omised placebo-controlled studies on different treatments , an evidence -based management approach has not yet been developed .
OBJECTIVE To critically review and synthesize data from a wide range of current therapeutic approaches to PBS/IC , to quantify the effect size from r and omised controlled trials ( RCTs ) , and to reach clinical agreement on the efficacy of treatments for PBS/IC .