Resiniferatoxin was not associated with sustained differences in the review outcomes reported but pain during instillation and withdrawal from treatment was significantly more common .
Groups treated with BCG tended to report less pain and fewer general symptoms .
Although adverse events were commonly reported , these were no more common after BCG than after placebo instillation .
The few data about Pentosanpolysulphate tended to favour the actively treated , but with wide confidence intervals ; there was little information about adverse events .
Oxybutinin instillation was associated with increased bladder capacity , reduced frequency , improved quality of life scores and fewer drop-outs .
Alkalinisation of urine pH did not make any clear difference , but with potentially wide confidence intervals .
BCG and oxybutin are reasonably well-tolerated and evidence is most promising for these .
Resiniferatoxin showed no evidence of effect for most outcomes and caused pain , which reduced treatment compliance .
There is little evidence for the other treatments included in this review .
BACKGROUND Painful Bladder Syndrome/Interstitial Cystitis ( PBS/IC ) occurs predominantly in women .
It is a poorly-understood condition with symptoms of bladder pain , urinary frequency , urgency and nocturia .
Treatments for PBS/IC include dietary/lifestyle interventions , oral medication , intravesical instillations and , in some cases , surgery .
Success rates are generally modest and there is little consensus as to the best form of treatment for this condition .
OBJECTIVES To assess the effectiveness of intravesical treatment for PBS/IC .
Intravesical resiniferatoxin for the treatment of interstitial cystitis: a randomized, double-blind, placebo controlled trial.
PURPOSE Interstitial cystitis is a painful bladder condition of unknown etiology and poorly understood pathophysiology . Current therapies have met with limited success . Vanilloid receptor agonists such as resiniferatoxin ( RTX ) desensitize C-fibers that transmit pain ; it is hypothesized that such drugs will be effective in the treatment of interstitial cystitis and painful bladder syndrome by decreasing the pain that leads to urinary frequency and urgency . MATERIAL S AND METHODS A r and omized , double-blind , placebo controlled study was conducted in 163 patients with interstitial cystitis . Participants were r and omly assigned to receive a single intravesical dose of 50 ml of either RTX 0.01 microM , 0.05 microM , 0.10 microM , or placebo .  Safety and efficacy was evaluated over 12 weeks . The primary efficacy endpoint was the Global Response Assessment , a 7-point scale rating overall change in symptoms of interstitial cystitis after 4 weeks . Secondary efficacy endpoints included reduction in pain , urgency , frequency , nocturia , average void volume , and the O'Leary-Sant Symptom and Problem Indexes . RESULTS RTX did not improve overall symptoms , pain , urgency , frequency , nocturia , or average void volume during 12 weeks followup . RTX result ed in a dose-dependent increase in the incidence of instillation pain , but was otherwise generally well tolerated . CONCLUSIONS In the largest prospect i ve , r and omized clinical trial reported to date with intravesical vanilloid therapy , single administration of RTX at doses of 0.01 microM to 0.10 microM was not effective in patients with interstitial cystitis
Resiniferatoxin was not associated with sustained differences in the review outcomes reported but pain during instillation and withdrawal from treatment was significantly more common .
Groups treated with BCG tended to report less pain and fewer general symptoms .
Although adverse events were commonly reported , these were no more common after BCG than after placebo instillation .
The few data about Pentosanpolysulphate tended to favour the actively treated , but with wide confidence intervals ; there was little information about adverse events .
Oxybutinin instillation was associated with increased bladder capacity , reduced frequency , improved quality of life scores and fewer drop-outs .
Alkalinisation of urine pH did not make any clear difference , but with potentially wide confidence intervals .
BCG and oxybutin are reasonably well-tolerated and evidence is most promising for these .
Resiniferatoxin showed no evidence of effect for most outcomes and caused pain , which reduced treatment compliance .
There is little evidence for the other treatments included in this review .
BACKGROUND Painful Bladder Syndrome/Interstitial Cystitis ( PBS/IC ) occurs predominantly in women .
It is a poorly-understood condition with symptoms of bladder pain , urinary frequency , urgency and nocturia .
Treatments for PBS/IC include dietary/lifestyle interventions , oral medication , intravesical instillations and , in some cases , surgery .
Success rates are generally modest and there is little consensus as to the best form of treatment for this condition .
OBJECTIVES To assess the effectiveness of intravesical treatment for PBS/IC .