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 injections for painful bladder syndrome: impact upon pain, psychological functioning and Quality of Life.
INTRODUCTION To assess the impact of intravesically injected botulinum A toxin ( BoNT/A ) upon bladder pain , urological complaints , symptoms of anxiety and depression , and Quality of Life ( QoL ) in patients with painful bladder symptoms ( PBS ) refractory to conventional treatment . PATIENTS AND METHODS In this prospect i ve study 14 patients received one injection of BoNT/A ( 200 U diluted in 20 ml 0.9 % NaCl ) , under cystoscopic guidance . At pre- and 3 months post- treatment all patients underwent an urological assessment ( voiding diary , urodynamics ) , a pain quantification on a visual analog scale ( VAS ) , an evaluation with the 14-item Hamilton Anxiety Rating Scale ( HAM-A ) to assess symptoms of psychic and somatic anxiety , an evaluation with the Hamilton Depression Rating Scale ( HAM-D ) to assess depression , and the 36-item Medical Outcomes Study Short Form ( SF-36 ) to assess QoL. Results . At pre-treatment all 14 patients had increased daytime and nighttime urinary frequency and high VAS scores . Nine patients had pathological HAM-A scores and all had pathological HAM-D scores . At the 3-month follow-up 10/14 patients reported a subjective improvement in pain . Mean VAS score , mean daytime and nighttime urinary frequency decreased significantly ( p < 0.01 , < 0.01 and < 0.01 , respectively ) . All domains in SF-36 and HAM-A significantly improved ( p<0.01 ) . All domains , except weight and sleep disorders , significantly improved in HAM-D , particularly somatoform symptoms ( p<0.01 ) , cognitive performance ( p<0.01 ) , and circadian variations ( p<0.01 ) . CONCLUSION In patients with refractory PBS with symptoms of anxiety , depression and poor QoL , BoNT/A intravesical treatment reduced bladder pain , improved psychological functioning , and well-being
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 .