Skip to main content

Advertisement

SpringerLink
Log in

Pharmacotherapy for Interstitial Cystitis/Bladder Pain Syndrome

  • Pharmacotherapies and Drug Development/Agents (ES Rovner, Section Editor)
  • Published:
Current Bladder Dysfunction Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Current literature regarding pharmacotherapy treatment strategies available for the management of interstitial cystitis/bladder pain syndrome (IC/BPS) will be addressed including oral, transdermal, and intravesical therapies. Pharmacotherapies with emerging data will be addressed, but the focus is on those treatments described by the AUA guidelines for IC/BPS.

Recent Findings

While multiple pharmacotherapy options for the management of IC/BPS exist, the evidence for most medical therapies is not strong and frequently yields mixed results. It has been over two decades since a new medication has gained FDA approval for the treatment of IC/BPS. This has prompted clinicians to reassess the approach to evaluating patients with IC/BPS, leading to the advent of phenotype-directed multimodal therapy.

Summary

Though national and international guidelines recommend a step-wise treatment algorithm beginning with the most conservative treatment options, the evidence for most therapies is mixed. Furthermore, recent randomized controlled trials of promising treatment options have yielded negative results, highlighting the importance of phenotype-directed classification to aid in the current management of IC/BPS and to allow for better research trial designs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Hanno P, Dmochowski R. Status of international consensus on interstitial cystitis/bladder pain syndrome/painful bladder syndrome: 2008 snapshot. Neurourol Urodyn [Internet]. 2009;28(4):274–86. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19260081.

    PubMed  Google Scholar 

  2. •• Hanno PM, Erickson D, Moldwin R, Faraday MM, American Urological Association. Diagnosis and treatment of interstitial cystitis/bladder pain syndrome: AUA guideline amendment. J Urol [Internet]. 2015 May;193(5):1545–53. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25623737. Outlines guideline-based therapy supported by the American Urological Aossociation.

  3. Cox A, Golda N, Nadeau G, Curtis Nickel J, Carr L, Corcos J, et al. CUA guideline: diagnosis and treatment of interstitial cystitis/bladder pain syndrome. Can Urol Assoc J [Internet]. 10(5–6):E136–55. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27790294.

    Google Scholar 

  4. •• Abrams P, Andersson K-E, Apostolidis A, Birder L, Bliss D, Brubaker L, et al. 6th International Consultation on Incontinence. Recommendations of the International Scientific Committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse and faecal incontinence. Neurourol Urodyn [Internet]. 2018 Sep;37(7):2271–2. Available from: http://www.ncbi.nlm.nih.gov/pubmed/30106223. Outlines guideline-based therapy supported by the International Continence Society.

    PubMed  Google Scholar 

  5. • Malde S, Palmisani S, Al-Kaisy A, Sahai A. Guideline of guidelines: bladder pain syndrome. BJU Int [Internet]. 2018 Nov;122(5):729–43. Available from: http://www.ncbi.nlm.nih.gov/pubmed/29777618. Summarizes major national and international society guidelines for IC/BPS.

  6. Fall M, Baranowski AP, Elneil S, Engeler D, Hughes J, Messelink EJ, et al. EAU guidelines on chronic pelvic pain. Eur Urol [Internet]. 2010 Jan;57(1):35–48. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19733958.

    PubMed  Google Scholar 

  7. Anderson VR, Perry CM. Pentosan polysulfate: a review of its use in the relief of bladder pain or discomfort in interstitial cystitis. Drugs [Internet]. 2006;66(6):821–35. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16706553.

    CAS  PubMed  Google Scholar 

  8. Sadhukhan PC, Tchetgen M-B, Rackley RR, Vasavada SP, Liou L, Bandyopadhyay SK. Sodium pentosan polysulfate reduces urothelial responses to inflammatory stimuli via an indirect mechanism. J Urol [Internet]. 2002 Jul;168(1):289–92. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12050558.

    CAS  PubMed  Google Scholar 

  9. Parsons CL. Bladder surface glycosaminoglycan: efficient mechanism of environmental adaptation. Urology [Internet]. 1986 Feb;27(2 Suppl):9–14. Available from: http://www.ncbi.nlm.nih.gov/pubmed/3946050.

  10. Holm-Bentzen M, Jacobsen F, Nerstrøm B, Lose G, Kristensen JK, Pedersen RH, et al. A prospective double-blind clinically controlled multicenter trial of sodium pentosanpolysulfate in the treatment of interstitial cystitis and related painful bladder disease. J Urol [Internet]. 1987 Sep;138(3):503–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/2442415.

    CAS  PubMed  Google Scholar 

  11. Mulholland SG, Hanno P, Parsons CL, Sant GR, Staskin DR. Pentosan polysulfate sodium for therapy of interstitial cystitis. A double-blind placebo-controlled clinical study. Urology [Internet]. 1990 Jun;35(6):552–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/1693797.

    CAS  PubMed  Google Scholar 

  12. Parsons CL, Benson G, Childs SJ, Hanno P, Sant GR, Webster G. A quantitatively controlled method to study prospectively interstitial cystitis and demonstrate the efficacy of pentosanpolysulfate. J Urol [Internet]. 1993 Sep;150(3):845–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/7688432.

    CAS  PubMed  Google Scholar 

  13. Sant GR, Propert KJ, Hanno PM, Burks D, Culkin D, Diokno AC, et al. A pilot clinical trial of oral pentosan polysulfate and oral hydroxyzine in patients with interstitial cystitis. J Urol [Internet]. 2003 Sep;170(3):810–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12913705.

    CAS  PubMed  Google Scholar 

  14. Nickel JC, Herschorn S, Whitmore KE, Forrest JB, Hu P, Friedman AJ, et al. Pentosan polysulfate sodium for treatment of interstitial cystitis/bladder pain syndrome: insights from a randomized, double-blind, placebo controlled study. J Urol [Internet]. 2015 Mar;193(3):857–62. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25245489.

    CAS  PubMed  Google Scholar 

  15. • van Ophoven A, Vonde K, Koch W, Auerbach G, Maag KP. Efficacy of pentosan polysulfate for the treatment of interstitial cystitis/bladder pain syndrome: results of a systematic review of randomized controlled trials. Curr Med Res Opin [Internet]. 2019 Mar 8;1–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/30849922. Systematic review of randomized controlled trials for pentosan polysulfate in the treatment of IC/BPS.

  16. Pearce WA, Chen R, Jain N. Pigmentary maculopathy associated with chronic exposure to pentosan polysulfate sodium. Ophthalmology [Internet]. 2018 Nov;125(11):1793–802. Available from: http://www.ncbi.nlm.nih.gov/pubmed/29801663.

  17. Ferguson TJ, Geraets RL, Barker MA. Chronic use of pentosan polysulfate sodium associated with risk of vision-threatening disease. Int Urogynecol J [Internet]. 2019 Mar;30(3):337–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/30612180.

    PubMed  Google Scholar 

  18. Fall M, Oberpenning F, Peeker R. Treatment of bladder pain syndrome/interstitial cystitis 2008: can we make evidence-based decisions? Eur Urol [Internet]. 2008 Jul;54(1):65–75. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18403099.

    PubMed  Google Scholar 

  19. Vij M, Srikrishna S, Cardozo L. Interstitial cystitis: diagnosis and management. Eur J Obstet Gynecol Reprod Biol [Internet]. 2012 Mar;161(1):1–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22310942.

  20. Hanno PM, Buehler J, Wein AJ. Use of amitriptyline in the treatment of interstitial cystitis. J Urol [Internet]. 1989 Apr;141(4):846–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/2926877.

    CAS  PubMed  Google Scholar 

  21. van Ophoven A, Pokupic S, Heinecke A, Hertle L. A prospective, randomized, placebo controlled, double-blind study of amitriptyline for the treatment of interstitial cystitis. J Urol [Internet]. 2004 Aug;172(2):533–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15247722.

  22. van Ophoven A, Hertle L. Long-term results of amitriptyline treatment for interstitial cystitis. J Urol [Internet]. 2005 Nov;174(5):1837–40. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16217303.

    PubMed  Google Scholar 

  23. Foster HE, Hanno PM, Nickel JC, Payne CK, Mayer RD, Burks DA, et al. Effect of amitriptyline on symptoms in treatment naïve patients with interstitial cystitis/painful bladder syndrome. J Urol [Internet]. 2010 May;183(5):1853–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20303115.

    PubMed  Google Scholar 

  24. Giusto LL, Zahner PM, Shoskes DA. An evaluation of the pharmacotherapy for interstitial cystitis. Expert Opin Pharmacother [Internet]. 2018;19(10):1097–108. Available from: http://www.ncbi.nlm.nih.gov/pubmed/29972328.

    CAS  PubMed  Google Scholar 

  25. Meares EM. Interstitial cystitis--1987. Urology [Internet]. 1987 Apr;29(4 Suppl):46–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/2882630.

  26. Dasgupta P, Sharma SD, Womack C, Blackford HN, Dennis P. Cimetidine in painful bladder syndrome: a histopathological study. BJU Int [Internet]. 2001 Aug;88(3):183–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11488726.

    CAS  PubMed  Google Scholar 

  27. Seshadri P, Emerson L, Morales A. Cimetidine in the treatment of interstitial cystitis. Urology [Internet]. 1994 Oct;44(4):614–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/7941209.

    CAS  PubMed  Google Scholar 

  28. Lewi H. Cimetidine in treatment of interstitial cystitis. Urology [Internet]. 1995 Jun;45(6):1088. Available from: http://www.ncbi.nlm.nih.gov/pubmed/7771018.

    CAS  PubMed  Google Scholar 

  29. Thilagarajah R, Witherow RO, Walker MM. Oral cimetidine gives effective symptom relief in painful bladder disease: a prospective, randomized, double-blind placebo-controlled trial. BJU Int [Internet]. 2001 Feb;87(3):207–12. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11167643.

  30. Theoharides TC. Hydroxyzine for interstitial cystitis. J Allergy Clin Immunol [Internet]. 1993 Feb;91(2):686–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8436783.

  31. Theoharides TC. Hydroxyzine in the treatment of interstitial cystitis. Urol Clin North Am [Internet]. 1994 Feb;21(1):113–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8284834.

  32. Theoharides TC, Sant GR. Hydroxyzine therapy for interstitial cystitis. Urology [Internet]. 1997 May;49(5A Suppl):108–10. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9146011.

  33. Forsell T, Ruutu M, Isoniemi H, Ahonen J, Alfthan O. Cyclosporine in severe interstitial cystitis. J Urol [Internet]. 1996 May;155(5):1591–3. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8627830.

    CAS  PubMed  Google Scholar 

  34. Forrest JB, Payne CK, Erickson DR. Cyclosporine A for refractory interstitial cystitis/bladder pain syndrome: experience of 3 tertiary centers. J Urol [Internet]. 2012 Oct;188(4):1186–91. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22901569.

    CAS  PubMed  Google Scholar 

  35. Ehrén I, Hallén Grufman K, Vrba M, Sundelin R, Lafolie P. Nitric oxide as a marker for evaluation of treatment effect of cyclosporine A in patients with bladder pain syndrome/interstitial cystitis type 3C. Scand J Urol [Internet]. 2013 Dec;47(6):503–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23600529.

    PubMed  Google Scholar 

  36. Sairanen J, Forsell T, Ruutu M. Long-term outcome of patients with interstitial cystitis treated with low dose cyclosporine A. J Urol [Internet]. 2004 Jun;171(6 Pt 1):2138–41. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15126772.

    CAS  PubMed  Google Scholar 

  37. Sairanen J, Tammela TLJ, Leppilahti M, Multanen M, Paananen I, Lehtoranta K, et al. Cyclosporine A and pentosan polysulfate sodium for the treatment of interstitial cystitis: a randomized comparative study. J Urol [Internet]. 2005 Dec;174(6):2235–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16280777.

  38. Simon LJ, Landis JR, Erickson DR, Nyberg LM. The Interstitial Cystitis Data Base Study: concepts and preliminary baseline descriptive statistics. Urology [Internet]. 1997 May;49(5A Suppl):64–75. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9146004.

    CAS  PubMed  Google Scholar 

  39. Wesselmann U. Interstitial cystitis: a chronic visceral pain syndrome. Urology [Internet]. 2001 Jun;57(6 Suppl 1):32–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11378048.

  40. Sasaki K, Smith CP, Chuang YC, Lee JY, Kim JC, Chancellor MB. Oral gabapentin (neurontin) treatment of refractory genitourinary tract pain. Tech Urol [Internet]. 2001 Mar;7(1):47–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11272678.

  41. Lee JW, Han DY, Jeong HJ. Bladder pain syndrome treated with triple therapy with gabapentin, amitriptyline, and a nonsteroidal anti-inflammatory drug. Int Neurourol J [Internet]. 2010 Dec;14(4):256–60. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21253338.

    PubMed  PubMed Central  Google Scholar 

  42. Kwon W-A, Ahn SH, Oh TH, Lee JW, Han DY, Jeong HJ. Effect of low-dose triple therapy using gabapentin, amitriptyline, and a nonsteroidal anti-inflammatory drug for overactive bladder symptoms in patients with bladder pain syndrome. Int Neurourol J [Internet]. 2013 Jun;17(2):78–82. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23869272.

    PubMed  PubMed Central  Google Scholar 

  43. Rovner E, Propert KJ, Brensinger C, Wein AJ, Foy M, Kirkemo A, et al. Treatments used in women with interstitial cystitis: the interstitial cystitis data base (ICDB) study experience. The Interstitial Cystitis Data Base Study Group. Urology [Internet]. 2000 Dec 20;56(6):940–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11113737.

  44. Lusty A, Kavaler E, Zakariasen K, Tolls V, Nickel JC. Treatment effectiveness in interstitial cystitis/bladder pain syndrome: Do patient perceptions align with efficacy-based guidelines? Can Urol Assoc J [Internet]. 2018 Jan;12(1):E1–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/29173267.

  45. Barua JM, Arance I, Angulo JC, Riedl CR. A systematic review and meta-analysis on the efficacy of intravesical therapy for bladder pain syndrome/interstitial cystitis. Int Urogynecol J [Internet]. 2016 Aug;27(8):1137–47. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26590137.

    PubMed  PubMed Central  Google Scholar 

  46. Sant GR, LaRock DR. Standard intravesical therapies for interstitial cystitis. Urol Clin North Am [Internet]. 1994 Feb;21(1):73–83. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8284849.

  47. Sant GR. Intravesical 50% dimethyl sulfoxide (Rimso-50) in treatment of interstitial cystitis. Urology [Internet]. 1987 Apr;29(4 Suppl):17–21. Available from: http://www.ncbi.nlm.nih.gov/pubmed/3551281.

  48. Perez-Marrero R, Emerson LE, Feltis JT. A controlled study of dimethyl sulfoxide in interstitial cystitis. J Urol [Internet]. 1988 Jul;140(1):36–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/3288775.

    CAS  PubMed  Google Scholar 

  49. Peeker R, Haghsheno MA, Holmäng S, Fall M. Intravesical bacillus Calmette-Guerin and dimethyl sulfoxide for treatment of classic and nonulcer interstitial cystitis: a prospective, randomized double-blind study. J Urol [Internet]. 2000 Dec;164(6):1912–5; discussion 1915–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11061879.

    CAS  PubMed  Google Scholar 

  50. Sairanen J, Leppilahti M, Tammela TLJ, Paananen I, Aaltomaa S, Taari K, et al. Evaluation of health-related quality of life in patients with painful bladder syndrome/interstitial cystitis and the impact of four treatments on it. Scand J Urol Nephrol [Internet]. 2009;43(3):212–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19137459.

    CAS  PubMed  Google Scholar 

  51. Tutolo M, Ammirati E, Castagna G, Klockaerts K, Plancke H, Ost D, et al. A prospective randomized controlled multicentre trial comparing intravesical DMSO and chondroïtin sulphate 2% for painful bladder syndrome/interstitial cystitis. Int Braz J Urol [Internet]. 43(1):134–41. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28124536.

  52. • Cervigni M, Sommariva M, Tenaglia R, Porru D, Ostardo E, Giammò A, et al. A randomized, open-label, multicenter study of the efficacy and safety of intravesical hyaluronic acid and chondroitin sulfate versus dimethyl sulfoxide in women with bladder pain syndrome/interstitial cystitis. Neurourol Urodyn [Internet]. 2017 Apr;36(4):1178–86. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27654012. Randomized controlled study of intravesical hyaluronic acid and chondroitin sulfate versus dimethyl sulfoxide in women with IC/BPS.

    PubMed  Google Scholar 

  53. Hanno PM, Parsons CL, Shrom SH, Fritz R, Mulholland SG. The protective effect of heparin in experimental bladder infection. J Surg Res [Internet]. 1978 Oct;25(4):324–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/152375.

    CAS  PubMed  Google Scholar 

  54. Nomiya A, Naruse T, Niimi A, Nishimatsu H, Kume H, Igawa Y, et al. On- and post-treatment symptom relief by repeated instillations of heparin and alkalized lidocaine in interstitial cystitis. Int J Urol [Internet]. 2013 Nov;20(11):1118–22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23432185.

    CAS  PubMed  Google Scholar 

  55. Parsons CL. Successful downregulation of bladder sensory nerves with combination of heparin and alkalinized lidocaine in patients with interstitial cystitis. Urology [Internet]. 2005 Jan;65(1):45–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15667861.

    PubMed  Google Scholar 

  56. Parsons CL, Housley T, Schmidt JD, Lebow D. Treatment of interstitial cystitis with intravesical heparin. Br J Urol [Internet]. 1994 May;73(5):504–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8012771.

    CAS  PubMed  Google Scholar 

  57. Kuo HC. Urodynamic results of intravesical heparin therapy for women with frequency urgency syndrome and interstitial cystitis. J Formos Med Assoc [Internet]. 2001 May;100(5):309–14. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11432309.

  58. Parsons CL, Zupkas P, Proctor J, Koziol J, Franklin A, Giesing D, et al. Alkalinized lidocaine and heparin provide immediate relief of pain and urgency in patients with interstitial cystitis. J Sex Med [Internet]. 2012 Jan;9(1):207–12. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22082303.

    CAS  PubMed  Google Scholar 

  59. Perez-Marrero R, Emerson LE, Maharajh DO, Juma S. Prolongation of response to DMSO by heparin maintenance. Urology [Internet]. 1993 Jan;41(1 Suppl):64–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8420097.

  60. Henry R, Patterson L, Avery N, Tanzola R, Tod D, Hunter D, et al. Absorption of alkalized intravesical lidocaine in normal and inflamed bladders: a simple method for improving bladder anesthesia. J Urol [Internet]. 2001 Jun;165(6 Pt 1):1900–3. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11371877.

    CAS  PubMed  Google Scholar 

  61. Asklin B, Cassuto J. Intravesical lidocaine in severe interstitial cystitis. Case report. Scand J Urol Nephrol [Internet]. 1989;23(4):311–2. Available from: http://www.ncbi.nlm.nih.gov/pubmed/2595329.

    CAS  PubMed  Google Scholar 

  62. Nickel JC, Moldwin R, Lee S, Davis EL, Henry RA, Wyllie MG. Intravesical alkalinized lidocaine (PSD597) offers sustained relief from symptoms of interstitial cystitis and painful bladder syndrome. BJU Int [Internet]. 2009 Apr;103(7):910–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19021619.

    CAS  PubMed  Google Scholar 

  63. Nickel JC, Jain P, Shore N, Anderson J, Giesing D, Lee H, et al. Continuous intravesical lidocaine treatment for interstitial cystitis/bladder pain syndrome: safety and efficacy of a new drug delivery device. Sci Transl Med [Internet]. 2012 18;4(143):143ra100. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22814850.

    PubMed  Google Scholar 

  64. Henry RA, Morales A, Cahill CM. Beyond a simple anesthetic effect: lidocaine in the diagnosis and treatment of interstitial cystitis/bladder pain syndrome. Urology [Internet]. 2015 May;85(5):1025–33. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25917728.

    PubMed  Google Scholar 

  65. Riedl CR, Engelhardt PF, Daha KL, Morakis N, Pflüger H. Hyaluronan treatment of interstitial cystitis/painful bladder syndrome. Int Urogynecol J Pelvic Floor Dysfunct [Internet]. 2008 May;19(5):717–21. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18097627.

    Google Scholar 

  66. Chintea CL, Belal M. Is there enough evidence for the use of intravesical instillations of glycosaminoglycan analogues in interstitial cystitis? BJU Int [Internet]. 2013 Feb;111(2):192–3. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23356746.

  67. Nordling J, van Ophoven A. Intravesical glycosaminoglycan replenishment with chondroitin sulphate in chronic forms of cystitis. A multi-national, multi-centre, prospective observational clinical trial. Arzneimittelforschung [Internet]. 2008;58(7):328–35. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18751498.

    Google Scholar 

  68. Steinhoff G, Ittah B, Rowan S. The efficacy of intravesicular sterile sodium chondroitin sulfate 0.2% in potassium tested positive patients with interstitial cystitis. Adv Exp Med Biol [Internet]. 2003;539(Pt B):731–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15176321.

  69. Nickel JC, Egerdie RB, Steinhoff G, Palmer B, Hanno P. A multicenter, randomized, double-blind, parallel group pilot evaluation of the efficacy and safety of intravesical sodium chondroitin sulfate versus vehicle control in patients with interstitial cystitis/painful bladder syndrome. Urology [Internet]. 2010 Oct;76(4):804–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20494413.

    PubMed  Google Scholar 

  70. Nickel JC, Hanno P, Kumar K, Thomas H. Second multicenter, randomized, double-blind, parallel-group evaluation of effectiveness and safety of intravesical sodium chondroitin sulfate compared with inactive vehicle control in subjects with interstitial cystitis/bladder pain syndrome. Urology [Internet]. 2012 Jun;79(6):1220–4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22516357.

    PubMed  Google Scholar 

  71. Thakkinstian A, Nickel JC. Efficacy of intravesical chondroitin sulphate in treatment of interstitial cystitis/bladder pain syndrome (IC/BPS): individual patient data (IPD) meta-analytical approach. Can Urol Assoc J [Internet]. 7(5–6):195–200. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23826048.

    PubMed  PubMed Central  Google Scholar 

  72. Bade JJ, Laseur M, Nieuwenburg A, van der Weele LT, Mensink HJ. A placebo-controlled study of intravesical pentosanpolysulphate for the treatment of interstitial cystitis. Br J Urol [Internet]. 1997 Feb;79(2):168–71. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9052464.

    CAS  PubMed  Google Scholar 

  73. Daha LK, Lazar D, Simak R, Pflüger H. The effects of intravesical pentosanpolysulfate treatment on the symptoms of patients with bladder pain syndrome/interstitial cystitis: preliminary results. Int Urogynecol J Pelvic Floor Dysfunct [Internet]. 2008 Jul;19(7):987–90. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18227956.

    Google Scholar 

  74. Davis EL, El Khoudary SR, Talbott EO, Davis J, Regan LJ. Safety and efficacy of the use of intravesical and oral pentosan polysulfate sodium for interstitial cystitis: a randomized double-blind clinical trial. J Urol [Internet]. 2008 Jan;179(1):177–85. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18001798.

  75. Fariello JY, Moldwin RM. Similarities between interstitial cystitis/bladder pain syndrome and vulvodynia: implications for patient management. Transl Androl Urol [Internet]. 2015 Dec;4(6):643–52. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26816866.

  76. Peters K, Girdler B, Carrico D, Ibrahim I, Diokno A. Painful bladder syndrome/interstitial cystitis and vulvodynia: a clinical correlation. Int Urogynecol J Pelvic Floor Dysfunct [Internet]. 2008 May;19(5):665–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18038212.

    Google Scholar 

  77. Fitzpatrick CC, DeLancey JO, Elkins TE, McGuire EJ. Vulvar vestibulitis and interstitial cystitis: a disorder of urogenital sinus-derived epithelium? Obstet Gynecol [Internet]. 1993 May;81(5 ( Pt 2)):860–2. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8469499.

  78. Goldstein AT, Pukall CF, Brown C, Bergeron S, Stein A, Kellogg-Spadt S. Vulvodynia: assessment and treatment. J Sex Med [Internet]. 2016 Apr;13(4):572–90. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27045258.

    PubMed  Google Scholar 

  79. Stenson AL. Vulvodynia: diagnosis and management. Obstet Gynecol Clin North Am [Internet]. 2017 Sep;44(3):493–508. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28778645.

  80. Capra P, Perugini P, Bleve M, Pavanetto P, Musitelli G, Rovereto B, et al. Innovative approach for interstitial cystitis: vaginal Pessaries loaded diazepam-A preliminary Study. J pharm [Internet]. 2013;2013:386546. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26555976.

    Google Scholar 

  81. Rogalski MJ, Kellogg-Spadt S, Hoffmann AR, Fariello JY, Whitmore KE. Retrospective chart review of vaginal diazepam suppository use in high-tone pelvic floor dysfunction. Int Urogynecol J [Internet]. 2010 Jul;21(7):895–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20066399.

    PubMed  Google Scholar 

  82. Chen H, Wang F, Chen W, Ye XT, Zhou Q, Shao F, et al. Efficacy of daily low-dose sildenafil for treating interstitial cystitis: results of a randomized, double-blind, placebo-controlled trial--treatment of interstitial cystitis/painful bladder syndrome with low-dose sildenafil. Urology [Internet]. 2014 Jul;84(1):51–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24837447.

    PubMed  Google Scholar 

  83. • Nickel JC, Egerdie B, Davis E, Evans R, Mackenzie L, Shrewsbury SB. A Phase II study of the efficacy and safety of the novel oral SHIP1 activator AQX-1125 in subjects with moderate to severe interstitial cystitis/bladder pain syndrome. J Urol [Internet]. 2016 Sep;196(3):747–54. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26968644. Promising phase II randomized double-blind trial on a novel therapy for IC/BPS.

    CAS  PubMed  Google Scholar 

  84. • Nickel JC, Moldwin R, Hanno P, Dmochowski R, Peters KM, Payne C, et al. Targeting the SHIP1 pathway fails to show treatment benefit in interstitial cystitis/bladder pain syndrome: lessons learned from evaluating potentially effective therapies in this enigmatic syndrome. J Urol [Internet]. 2019 Feb 15;101097JU0000000000000192. Available from: http://www.ncbi.nlm.nih.gov/pubmed/31090511. Phase III trial of novel therapy for IC/BPS that failed to show the benefit that the phase II trial showed.

  85. Qu H-C, Zhang W, Yan S, Liu Y-L, Wang P. Urinary nerve growth factor could be a biomarker for interstitial cystitis/painful bladder syndrome: a meta-analysis. PLoS One [Internet]. 2014;9(9):e106321. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25181532.

    PubMed  PubMed Central  Google Scholar 

  86. Evans RJ, Moldwin RM, Cossons N, Darekar A, Mills IW, Scholfield D. Proof of concept trial of tanezumab for the treatment of symptoms associated with interstitial cystitis. J Urol [Internet]. 2011 May;185(5):1716–21. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21420111.

    CAS  PubMed  Google Scholar 

  87. • Nickel JC, Mills IW, Crook TJ, Jorga A, Smith MD, Atkinson G, et al. Tanezumab reduces pain in women with interstitial cystitis/bladder pain syndrome and patients with nonurological associated somatic syndromes. J Urol [Internet]. 2016 Apr;195(4 Pt 1):942–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26576710. Pooled analysis of three small clinical trials showing pain reduction in women with IC/BPS and concomitant somatic syndromes who were treated with a monoclonal antibody against nerve growth factor.

    CAS  PubMed  Google Scholar 

  88. Shoskes DA, Nickel JC, Rackley RR, Pontari MA. Clinical phenotyping in chronic prostatitis/chronic pelvic pain syndrome and interstitial cystitis: a management strategy for urologic chronic pelvic pain syndromes. Prostate Cancer Prostatic Dis [Internet]. 2009;12(2):177–83. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18645581.

    PubMed  Google Scholar 

  89. Nickel JC, Shoskes D, Irvine-Bird K. Clinical phenotyping of women with interstitial cystitis/painful bladder syndrome: a key to classification and potentially improved management. J Urol [Internet]. 2009 Jul;182(1):155–60. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19447429.

    PubMed  Google Scholar 

  90. •• Crane A, Lloyd J, Shoskes DA. Improving the utility of clinical phenotyping in interstitial cystitis/painful bladder syndrome: from UPOINT to INPUT. Can J Urol [Internet]. 2018;25(2):9250–4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/29680002. Creation of a novel clinical phenotyping system for IC/BPS.

  91. International Painful Bladder Foundation Interstitial cystitis/painful bladder syndrome: anesthetic intravesical cocktails, http://painful-bladder.org/pdf/IPBF.intravesicalcocktails.pdf. Accessed May 2019.

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Medical University of South Carolina, 96 Jonathan Lucas St. CSB 644, Charleston, SC, 29425, USA

    Alyssa Greiman & Lindsey Cox

Authors
  1. Alyssa Greiman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lindsey Cox
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lindsey Cox.

Ethics declarations

Conflict of Interest

Lindsey Cox declares that she has no conflict of interest.

Alyssa Greiman declares that she has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Pharmacotherapies and Drug Development/Agents

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Greiman, A., Cox, L. Pharmacotherapy for Interstitial Cystitis/Bladder Pain Syndrome. Curr Bladder Dysfunct Rep 14, 365–376 (2019). https://doi.org/10.1007/s11884-019-00540-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11884-019-00540-9

Keywords

Search

Navigation