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 randomized double-blind trial of oral L-arginine for treatment of interstitial cystitis.
PURPOSE Nitric oxide synthase activity is decreased in the urine of patients with interstitial cystitis compared to the urine of controls . In a preliminary trial oral L-arginine , the substrate for nitric oxide synthase , increased urinary nitric oxide synthase activity and improved interstitial cystitis symptoms . This r and omized , double-blind , placebo controlled study further investigates the efficacy of L-arginine treatment for interstitial cystitis . MATERIAL S AND METHODS A total of 53 interstitial cystitis patients were assigned to receive daily 1,500 mg . L-arginine or placebo orally for 3 months . Interstitial cystitis symptoms were assessed by interviews at 2 weeks , and 1 , 2 and 3 months . RESULTS The trial was completed by 21 of 27 patients in the L-arginine group and 25 of 26 in the placebo group . Using per protocol analysis 29 % ( 6 of 21 patients ) in the L-arginine group and 8 % ( 2 of 25 ) in the placebo group were clinical ly improved by the end of the trial ( p = 0.07 ) . A Likert scale showed greater global improvement in the L-arginine group ( 48 % , 10 of 21 ) compared to the placebo group ( 24 % , 6 of 25 ) at 3 months ( p = 0.05 ) with a decrease in pain intensity ( p = 0.04 ) , and tendency toward improvement in urgency ( p = 0.06 ) and frequency of pain ( p = 0.09 ) . Using an intention to treat approach to analysis there were no differences between groups . CONCLUSIONS Oral L-arginine ( 1,500 mg . daily ) may decrease pain and urgency in a subset of interstitial cystitis patients
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 .