Current evidence also suggests the efficacy of  dimethyl sulfoxide and amitryptyline therapy .
Hydroxyzine , intravesical bacille Calmette-Guérin  , and  resiniferatoxin therapy  failed to demonstrate efficacy , but evidence was inconclusive owing to method ological limitations .
Pentosan polysulfate may be modestly beneficial for symptoms of PBS/IC .
There is insufficient evidence for other pharmacologic treatments .
BACKGROUND More than 180 different types of therapy have been used in the treatment and management of  painful bladder syndrome/interstitial cystitis ( PBS/IC ) , yet evidence from clinical trials remains inconclusive .
This study aim ed to evaluate the efficacy of pharmacologic approaches to PBS/IC , to quantify the effect size from r and omized controlled trials , and to begin to inform a clinical consensus of treatment efficacy for PBS/IC .
A prospective double-blind clinically controlled multicenter trial of sodium pentosanpolysulfate in the treatment of interstitial cystitis and related painful bladder disease.
Painful bladder disease , sensory bladder disease , chronic abacterial cystitis and interstitial cystitis are ill-defined conditions of unknown etiology and pathogenesis , and , therefore , they are without any rational therapy . Pathogenetic theories concerning defects in the epithelium and /or mucous surface coat ( including glycosaminoglycans ) of the bladder , and theories concerning immunological disturbances predominate . Sodium pentosanpolysulfate ( Elmiron ) acts by substituting a defective glycosaminoglycan layer and inhibits complement reactions in inflammatory processes . We compared sodium pentosanpolysulfate versus placebo in a prospect i ve double-blind , clinical ly controlled multicenter trial of 115 patients with painful bladder disease . Two protocol s were used . Protocol A included 43 patients with clinical ly and pathologically anatomically verified interstitial cystitis ( 28 or more mast cells per mm.2 ) , and protocol B included 72 patients with a painful bladder and unspecific histological findings . The patients were r and omized to receive either sodium pentosanpolysulfate ( 200 mg . twice daily ) or placebo capsules for 4 months . Before and after the trial the patients were evaluated with symptom grading , urodynamics and cystoscopy with distension and deep bladder biopsies . The results showed no difference between the pre-trial and post-trial values in the sodium pentosanpolysulfate and placebo groups in both protocol s in regard to symptoms , urodynamic parameters , cystoscopic appearance and mast cell counts . A significant increase in the cystoscopically determined bladder capacity in the sodium pentosanpolysulfate group in protocol A was found . We conclude that no statistically or clinical ly significant effect of sodium pentosanpolysulfate was found compared to placebo in patients with painful bladder disease
Current evidence also suggests the efficacy of  dimethyl sulfoxide and amitryptyline therapy .
Hydroxyzine , intravesical bacille Calmette-Guérin  , and  resiniferatoxin therapy  failed to demonstrate efficacy , but evidence was inconclusive owing to method ological limitations .
Pentosan polysulfate may be modestly beneficial for symptoms of PBS/IC .
There is insufficient evidence for other pharmacologic treatments .
BACKGROUND More than 180 different types of therapy have been used in the treatment and management of  painful bladder syndrome/interstitial cystitis ( PBS/IC ) , yet evidence from clinical trials remains inconclusive .
This study aim ed to evaluate the efficacy of pharmacologic approaches to PBS/IC , to quantify the effect size from r and omized controlled trials , and to begin to inform a clinical consensus of treatment efficacy for PBS/IC .