Current evidence also suggests the efficacy of  dimethyl sulfoxide and amitryptyline therapy .
Hydroxyzine , intravesical bacille Calmette-Guérin  , and  resiniferatoxin therapy  failed to demonstrate efficacy , but evidence was inconclusive owing to method ological limitations .
Pentosan polysulfate may be modestly beneficial for symptoms of PBS/IC .
There is insufficient evidence for other pharmacologic treatments .
BACKGROUND More than 180 different types of therapy have been used in the treatment and management of  painful bladder syndrome/interstitial cystitis ( PBS/IC ) , yet evidence from clinical trials remains inconclusive .
This study aim ed to evaluate the efficacy of pharmacologic approaches to PBS/IC , to quantify the effect size from r and omized controlled trials , and to begin to inform a clinical consensus of treatment efficacy 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
Current evidence also suggests the efficacy of  dimethyl sulfoxide and amitryptyline therapy .
Hydroxyzine , intravesical bacille Calmette-Guérin  , and  resiniferatoxin therapy  failed to demonstrate efficacy , but evidence was inconclusive owing to method ological limitations .
Pentosan polysulfate may be modestly beneficial for symptoms of PBS/IC .
There is insufficient evidence for other pharmacologic treatments .
BACKGROUND More than 180 different types of therapy have been used in the treatment and management of  painful bladder syndrome/interstitial cystitis ( PBS/IC ) , yet evidence from clinical trials remains inconclusive .
This study aim ed to evaluate the efficacy of pharmacologic approaches to PBS/IC , to quantify the effect size from r and omized controlled trials , and to begin to inform a clinical consensus of treatment efficacy for PBS/IC .