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 .
Clinical and immunological response to nifedipine for the treatment of interstitial cystitis.
Nifedipine is a calcium channel antagonist known to inhibit smooth muscle contraction and cell-mediated immunity . The clinical and local immune response to nifedipine was investigated in an open trial with 10 female interstitial cystitis patients , whose disease was diagnosed according to the consensus criteria developed in 1987 at a National Institutes of Health workshop . To evaluate the symptoms and clinical response of the patients objective ly we scored the symptoms of frequency , urgency , nocturia , dysuria and suprapubic pain on a scale of 0 to 2 . Nifedipine was administered as a single daily dose determined by a dose-titration test . Urinary interleukin-2 inhibitor activity , a marker of cell-mediated inflammation , was measured using a murine interleukin-2 dependent cell line . Before nifedipine therapy the symptom scores ( total of the 5 symptoms ) ranged between 5 and 9 , and after 2 months they ranged between 0 and 6 . Of the 9 patients followed for at least 4 months only 1 failed to have a significant clinical improvement , 5 showed at least a 50 % decrease in symptom scores and 3 were asymptomatic . Drug side effects were minimal . Urinary interleukin-2 inhibitor activity before nifedipine therapy confirmed the presence of cell-mediated inflammation . After 4 months of therapy interleukin-2 inhibitor activity was normal in 7 of 9 patients regardless of the severity of symptoms , which indicated that nifedipine exerted an immunosuppressive effect . Although our data suggest that nifedipine is an efficacious , well tolerated , convenient oral medication for the treatment of interstitial cystitis , the true value of nifedipine for patients with this disease must be determined by a prospect i ve , r and omized trial of nifedipine versus placebo
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 .