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 capsaicin for treatment of severe bladder pain: a randomized placebo controlled study.
PURPOSE Present therapeutic approaches to control bladder pain are clinical ly and scientifically unsatisfactory , and pain in the lower urinary tract remains a challenge even to the skilled urologist . A r and omized placebo controlled study was done to evaluate intravesical capsaicin for severe bladder pain . Followup was 6 months . MATERIAL S AND METHODS A total of 36 patients was prospect ively r and omized into those receiving 10 microM. intravesical capsaicin twice weekly for 1 month ( group 1 ) or placebo ( group 2 ) . All patients had pelvic pain for at least 6 months , and had 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 immediately at the end of treatment ( primary end point ) and 6 months later ( secondary end point ) . RESULTS Both groups were adequately homogeneous with regard to age , sex ratio , duration of disease , voiding pattern and pain score . At both end points group 1 had significant improvement in frequency and nocturia but no improvement in urgency . No change was noted in group 2 . A significant decrease in pain score was found in group 1 at the primary ( mean plus or minus st and ard deviation 3.22 + /- 0.42 , p < 0.01 ) and secondary ( 3.83 + /- 0.47 , p < 0.01 ) end points compared to before treatment ( 5.61 + /- 0.40 , chi-square with 2 degrees of freedom 29.25 , p < 0.0001 ) . A significant improvement was also observed in the placebo group , in which the pretreatment pain score ( 5.47 + /- 0.37 ) was decreased at the primary ( 4.47 + /- 0.36 , p < 0.01 ) and secondary ( 4.48 + /- 0.34 , p < 0.01 , chi-square with 2 degrees of freedom 12.71 , p < 0.002 ) end points . There were no statistically significant differences between the 2 groups . CONCLUSIONS We confirmed the beneficial effect of intravesical instillation of capsaicin on voiding pattern in patients with hypersensitive disorders ( frequency and nocturia ) . We could not confirm improvement in pain score after capsaicin treatment compared to placebo . Possibly a larger dose of capsaicin would be more effective in controlling pain and neurological disease of the bladder
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 .