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 .
Cyclosporine in severe interstitial cystitis.
PURPOSE Cyclosporine is a widely used immunosuppressive drug in organ transplantation and recently it has been used in several autoimmune disorders with good results . Because interstitial cystitis may have an autoimmune etiology , we wished to determine whether cyclosporine has any effect on symptoms in patients with severe interstitial cystitis . MATERIAL S AND METHODS A total of 11 patients , who fulfilled the criteria for interstitial cystitis according to an international accrual form , received cyclosporine for 3 to 6 months at an initial dose of 2.5 to 5 mg./kg . daily and a maintenance dose of 1.5 to 3 mg./kg . daily .  Blood pressure , serum creatinine and cyclosporine concentrations were monitored regularly . The patients completed frequency-volume charts at 2-week intervals . RESULTS The frequency-volume charts showed favorable effects . Micturition frequency decreased ( p<0.01 ) , and mean and maximum voided volumes increased significantly ( p<0.001 and p<0.01 , respectively ) . Bladder pain decreased or disappeared in 10 patients , allowing for storage of large urine volumes . Serum creatinine did not change with the dosages used . Mild hypertension occurred in 2 patients and resolved after the cyclosporine dose was lowered . After cessation of treatment symptoms recurred in the majority of patients . CONCLUSIONS The findings revive the concept of interstitial cystitis as an autoimmune 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 .