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 hypersensitive disorder: a randomized placebo controlled study.
PURPOSE Present therapeutic approaches to control hypersensitive disorder of the lower urinary tract and bladder pain are clinical ly and scientifically unsatisfactory . We performed a r and omized placebo controlled study with followup after 1 and 3 months using intravesical resiniferatoxin to treat hypersensitive disorder and bladder pain . MATERIAL S AND METHODS We prospect ively r and omized 18 patients into 2 groups to receive a single dose of 10 nM. resiniferatoxin intravesically ( group 1 ) or a placebo saline solution only ( group 2 ) . All patients had at least a 6-month history of frequency , nocturia , urgency and symptoms of pelvic pain as well as no urinary tract infection within the last 3 months , functional disorders of the lower urinary tract , or other vesical or urethral pathology . Pretreatment voiding pattern and pain score were recorded . Patients were evaluated after 30 days ( primary end point ) and 3 months ( secondary end point ) . RESULTS The 2 groups were adequately homogeneous in regard to patient age , sex ratio , disease duration , voiding pattern and pain score . At the primary end point mean frequency plus or minus st and ard error of mean was decreased from 12 . 444 + /- 0.70 voids to 7.111 + /- 0.67 and nocturia from 3.777 + /- 0 . 27 to 1.666 + /- 0.16 ( p < 0.01 ) . We observed a lesser significant improvement in mean frequency in group 1 at the secondary end point to 10.444 + /- 0.94 voids ( p < 0.05 ) . No significant modification was noted in patients assigned to placebo .  Mean pain score significantly decreased in group 1 at the primary end point from 5.555 + /- 0.29 to 2.666 + /- 0.23 ( p < 0.01 ) but not at the secondary end point ( 4.777 + /- 0.66 , p > 0.05 ) . No statistically significant improvement in mean pain score was observed in placebo group 2 . During resiniferatoxin infusion 4 group 1 patients noticed a light warm or burning sensation at the suprapubic and /or urethral level . CONCLUSIONS Intravesical resiniferatoxin may significantly improve the voiding pattern and pain score in patients with hypersensitive disorder and bladder pain . Because resiniferatoxin did not cause a significant warm or burning sensation at the suprapubic and /or urethral level , it may be considered a new strategy for treating hypersensitive disorder and bladder pain . However , further studies are necessary to confirm our results and define the resiniferatoxin mechanism of action , dose and necessary treatment schedule
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 .