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 .
Use of the neodymium: YAG laser for interstitial cystitis: a prospective study.
PURPOSE Interstitial cystitis is a disorder of the bladder characterized by urgency and frequency of urination , and pelvic pain . The classic type of interstitial cystitis is characterized by Hunner 's ulcers , which are focal regions of severe bladder inflammation . Patients with Hunner 's ulcers tend to have more severe symptoms and are often refractory to medical management . We present a prospect i ve series of patients who underwent ablative therapy of Hunner 's ulcers using a neodymium (Nd):YAG laser . MATERIAL S AND METHODS A total of 24 patients with interstitial cystitis underwent ablative therapy for Hunner 's ulcers . Medical therapy had failed in all cases . Using regional or general anesthesia the Nd : YAG laser under cystoscopic control was used to ablate the ulcers . The power setting was 15 W. with a firing duration of between 1 and 3 seconds . The procedure was performed on an outpatient basis . Symptoms were noted preoperatively and postoperatively . RESULTS All patients had symptom improvement within 2 to 3 days . The mean pain scores decreased from 9.1 to 1.2 ( p < 0.003 ) , the mean urgency score decreased from 8.2 to 1.9 ( p < 0.003 ) , the mean voiding interval increased from every 30 minutes to every 102 ( p < 0.0001 ) and nocturia decreased from a mean of 7.9 voids per night to 2.9 ( p < 0.0001 ) . There were no complications . Mean followup was 23 months . However , relapse in 11 patients required 1 to 4 additional treatments . The re-treatment response was similar to the initial treatment . CONCLUSIONS Nd : YAG laser ablation of Hunner 's ulcers is an excellent , minimally invasive method of treating interstitial cystitis . While it is not a cure , it offers patients an opportunity to have decreased symptoms for an extended period and it may be repeated as necessary
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 .