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 .
Botulinum A toxin intravesical injection in patients with painful bladder syndrome: 1-year followup.
PURPOSE We evaluated the 1-year efficacy and tolerability of botulinum A toxin intravesically injected in patients with painful bladder symptoms associated with increased urinary frequency , refractory to conventional treatments . MATERIAL S AND METHODS Three men and 12 women were prospect ively included in the study . Under short general anesthesia the patients were given injections of 200 U commercially available botulinum A toxin diluted in 20 ml 0.9 % NaCl . Injections were performed submucosally in the bladder trigone and lateral walls under cystoscopic guidance . A voiding chart and the visual analog scale for pain were used , and urodynamics were performed before treatment , and 1 , 3 , 5 and 12 months later . RESULTS Overall 13 patients ( 86.6 % ) reported subjective improvement at the 1 and 3-month followups . The mean visual analog scale score , and daytime and nighttime urinary frequency were significantly decreased ( p < 0.05 , < 0.01 and < 0.05 , respectively ) . At the 5-month followup the beneficial effects persisted in 26.6 % of cases but increased daytime and nighttime urinary frequency , and an increased visual analog scale score were observed compared to baseline . At 12 months after treatment pain recurred in all patients . Nine patients complained of dysuria 1 month after treatment . Dysuria persisted in 4 cases at the 3-month followup and in 2 at the 5-month followup . CONCLUSIONS Intravesically injected botulinum toxin A is effective for short-term management of refractory painful bladder syndrome . The beneficial effects decreased progressively within a few months after treatment . Thus , repeat injections of the neurotoxin are required for efficacious treatment in patients with the disease
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 .