Skip to main content

Advertisement

SpringerLink
Log in

Painful Bladder Syndrome: An Update and Review of Current Management Strategies

  • Female Urology (K Kobashi, Section Editor)
  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

Interstitial cystitis/painful bladder syndrome (IC/PBS) remains a prevalent, but untreated disease with a poorly understood pathophysiology. Nonetheless, four main processes currently appear to be involved in producing IC/PBS symptoms: (1) disruption of the bladder GAG/proteoglycan layer, (2) upregulated immune/inflammatory response, (3) neural upregulation, and (4) pelvic floor dysfunction. Current and emerging therapies aimed at these potential targets will be the focus of this review with an update on IC/PBS therapy.

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

Similar content being viewed by others

References

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

  1. Skene AJC. Diseases of the bladder and urethra in women. New York, NY: Wm Wood; 1887. p. 167.

    Google Scholar 

  2. Hunner GL. A rare type of bladder ulcer in women: report of cases. Boston Med Surg J. 1915;172:660–4.

    Google Scholar 

  3. Hand JR. Interstitial cystitis: report of 223 cases (204 women and 19 men). J Urology. 1949;61:291–309.

    CAS  Google Scholar 

  4. Hanno PM, Allen D, Burks JQ, Roger C, et al. AUA guidelines for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome. J Urol. 2011;185:2162–70. AUA Guidelines based upon a systematic review of the literature through July, 2009. The guideline panel identifies an overall management strategy for IC/PBS using clinical principles and expert opinion.

    PubMed  Google Scholar 

  5. Gillenwater JY, Wein AJ. Summary of the National Institute of Arthritis, Diabetes, Digestive and Kidney Diseases Workshop on Interstitial Cystitis, National Institutes of Health, Bethesda, MD, August 28–29, 1987. J Urology. 1988;140:203–6.

    CAS  Google Scholar 

  6. Fall M, Oberpenning F, Peeker R. Treatment of bladder pain syndrome/interstitial cystitis 2008: can we make evidence-based decisions? Eur Urology. 2008;54(1):65–75.

    Google Scholar 

  7. Hanno P, Dmochowski R. Status of international consensus on interstitial cystitis/bladder pain syndrome/painful bladder syndrome: 2008 snapshot. Neurourol Urodyn. 2009;28:274.

    PubMed  Google Scholar 

  8. Elliott CS, Payne CK. Interstitial cystitis and the overlap with overactive bladder. Curr Urol Rep. 2012;13(5):319–26.

    PubMed  Google Scholar 

  9. Leppilahti M, Tammela TL, Heini H, et al. Prevalence of symptoms related to interstitial cystitis in women: a population based study in Finland. J Urology. 2002;168:139.

    Google Scholar 

  10. Lifford KL, Curhan GC. Prevalence of painful bladder syndrome in older women. J Urol. 2008;73:494.

    Google Scholar 

  11. Rosenberg MT, Hazzard M. Prevalence of interstitial cystitis symptoms in women: a population based study in the primary care office. J Urology. 2005;174:2231–4.

    Google Scholar 

  12. Clemens JQ, Meenan RT, O’Keeffe, et al. Prevalence of interstitial cystitis symptoms in a managed care population. J Urology. 2005;174:576–80.

    Google Scholar 

  13. Inoue Y, Mita K, Kakehashi M, Kato M, Usui T. Prevalence of painful bladder syndrome (PBS) symptoms in adult women in the general population in Japan. Neurourol Urodyn. 2009;28(3):214–8.

    PubMed  Google Scholar 

  14. Berry S, Bogart L, Phama C, Liua K, Nybergc L, Stotoa M, et al. Development, Validation and Testing of an Epidemiological Case Definition of Interstitial Cystitis/Painful Bladder Syndrome. J Urology. 2010;183:1848–52.

    Google Scholar 

  15. Fall M, Baranowski AP, Elneil S, Engeler D, Hughes J, Messelink EJ, et al. ; European Association of Urology. EAU guidelines on chronic pelvic pain. Eur Urology. 2010;57(1):35–48.

    Google Scholar 

  16. Parsons CL. The role of the urinary epithelium in the pathogenesis of interstitial cystitis/prostatitis/urethritis. Urology. 2007;69:9–16.

    PubMed  Google Scholar 

  17. Hurst RE, Zebrowski R. Identification of proteoglycans present at high density on bovine and human bladder luminal surface. J Urol. 1994;152:1641–5.

    CAS  PubMed  Google Scholar 

  18. Neuhaus J et al. Individual receptor profiling as a novel tool to support diagnosis of bladder pain syndrome/interstitial cystitis (IC/PBS/IC). World J Urol. 2012;30:693–700.

    PubMed  Google Scholar 

  19. Ford AP, Gever JR, Nunn PA, et al. Purinoceptors as therapeutic targets for lower urinary tract dysfunction. Br J Pharmacol. 2006;147:S132–43.

    CAS  PubMed  Google Scholar 

  20. Murkerji G, Yiangou U, Grogono J, et al. Localization of M2 and M3 muscarinic receptors in human bladder disorders and their clinical correlations. J Urology. 2006;176:367–73.

    Google Scholar 

  21. Meares EM. Interstitial cystitis 1987. Urology. 1987;29(Suppl):46–8.

    PubMed  Google Scholar 

  22. Nazif O, Teichman JM, Gebhart GF. Neural upregulation in interstitial cystitis. Urology. 2007;69(4 Suppl):24–33.

    PubMed  Google Scholar 

  23. Twiss C, Kilpatrick L, Craske M, Buffington CA, Ornitz E, Rodríguez LV, et al. Increased startle responses in interstitial cystitis: evidence for central hyperresponsiveness to visceral related threat. J Urol. 2009;181(5):2127–33.

    PubMed  Google Scholar 

  24. Cervigni M, Natale F, Nasta L, Padoa A, Voi R, Porru D. A combined intravesical therapy with hyaluronic acid and chondroitin for refractory painful bladder syndrome/interstitial cystitis. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19:943–7.

    CAS  PubMed  Google Scholar 

  25. Shorter B, Lesser M, Moldwin R, Kushner L. Effect of comestibles on symptoms of interstitial cystitis. J Urology. 2007;178:145–52.

    Google Scholar 

  26. Fisher BP, Bavendam TG, Roberts BW, et al. Blinded placebo controlled evaluation on the ingestion of acidic foods and their effect on urinary pH and the symptomatology of interstitial cystitis. FL, NIDDK: Orlando; 1993. p. 53.

    Google Scholar 

  27. Friedlander JI, Shorter B, Moldwin RM. Diet and its role in interstitial cystitis/bladder pain syndrome (IC/IC/PBS) and comorbid conditions. BJU Int. 2012;109(11):1584–91.

    PubMed  Google Scholar 

  28. Bassaly R, Downes K, Hart S. Dietary consumption triggers in interstitial cystitis/bladder pain syndrome. Female Pelvic Med Reconstr Surg. 2011;17(1):36–9.

    PubMed  Google Scholar 

  29. Fitzgerald MP, Anderson RU, Potts J, et al. Randomized multi- center feasibility trial of myofascial physical therapy for the treatment of urological chronic pelvic pain syndromes. J Urol. 2009;182:570–80.

    PubMed Central  PubMed  Google Scholar 

  30. Simons DG, Travell JG, Simons LS. Travell and Simons Myofascial Pain and Dysfunction: The Trigger Point Manual (2nd ed), vol. 1. Baltimore: Williams &Wilkins; 1999.

    Google Scholar 

  31. Schmidt RA, Vapnek JM. Pelvic floor behavior and interstitial cystitis. Semin Urology. 1991;9:154.

    CAS  Google Scholar 

  32. Weiss JM. Pelvic floor myofascial trigger points: manual therapy for interstitial cystitis and the urgency-frequency syndrome. J Urology. 2001;166:2226–31.

    CAS  Google Scholar 

  33. Fitzgerald et al. Randomized multicenter feasibility trail of myofascial physical therapy for the treatment of urological chronic pelvic pain syndrome. J Urology. 2013;189:S75–85. Randomized clinical trial comparing global therapeutic massage to myofascial physical therapy. This study demonstrated a statistically significant beneficial effect of myofacial physical therapy in the treatment of IC/PBS.

    Google Scholar 

  34. Ortho-McNeil Pharmaceutical I. Elmiron® 100 mg (pentosan polysulfate sodium) capsules [online]. Available from URL: http://www.orthoelmiron.com.

  35. Parsons CL. The therapeutic role of sulfated polysaccharides in the urinary bladder. Urol Clin North Am. 1994;21(1):93–100.

    CAS  PubMed  Google Scholar 

  36. Parsons CL, Forrest J, Nickel JC, et al. Effect of pentosan polysulfate therapy on intravesical potassium sensitivity. Urology. 2002;59(3):329–33.

    PubMed  Google Scholar 

  37. 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 Urology. 2008;179(1):177–85.

    CAS  Google Scholar 

  38. Mulholland SG, Hanno P, Parsons CL, et al. Pentosan polysulfate sodium for therapy of interstitial cystitis: a double-blind placebo-controlled clinical study. Urology. 1990;35(6):552–8.

    CAS  PubMed  Google Scholar 

  39. Parsons CL, Benson G, Childs SJ, et al. A quantitatively controlled method to study prospectively interstitial cystitis and demonstrate the efficacy of pentosanpolysulfate. J Urology. 1993;150(3):845–8.

    CAS  Google Scholar 

  40. Holm-Bentzen M, Jacobsen F, Nerstrom B, 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 Urology. 1987;138:503.

    CAS  Google Scholar 

  41. Nickel JC, Barkin J, Forrest J, Mosbaugh PG, Hernandez-Graulau J, Kaufman D, et al. Randomized, double-blind, dose-ranging study of pentosan polysulfate sodium for interstitial cystitis. Urology. 2005;65(4):654–8.

    PubMed  Google Scholar 

  42. Glazener CMA, Evans JHC, Peto R. Tricyclic and related drugs for nocturnal enuresis in children. Cochrane Database of Systematic Reviews 2003, Issue 3.

  43. Pranikoff K, Constantino G. The use of amitriptyline in patients with urinary frequency and pain. Urology. 1998;51(5A Suppl):179–81.

    CAS  PubMed  Google Scholar 

  44. Van Ophoven A, Pokupic S, Heinecke A, et al. A prospective, randomized, placebo controlled, double-blind study of amitriptyline for the treatment of interstitial cystitis. J Urology. 2004;172:533.

    Google Scholar 

  45. Fenton BW. Limbic associated pelvic pain: a hypothesis to explain the diagnostic relationships and features of patients with chronic pelvic pain. Med Hypotheses. 2007;69(2):282–6.

    PubMed  Google Scholar 

  46. Foster Jr HE, Hanno PM, Nickel JC, Payne CK, Mayer RD, Burks DA, et al. Interstitial Cystitis Collaborative Research Network. Effect of amitriptyline on symptoms in treatment naïve patients with interstitial cystitis/painful bladder syndrome. J Urology. 2010;183(5):1853–8.

    Google Scholar 

  47. Hanno PM, Buehler J, Wein AJ. Use of amitriptyline in the treatment of interstitial cystitis. J Urology. 1989;141:846.

    CAS  Google Scholar 

  48. Thilagarajah R, Witherow RO'N, Walker MM. Quantitative histopathology can aid diagnosis in painful bladder syndrome. J Clin Pathol. 1998;51:211–4.

    CAS  PubMed  Google Scholar 

  49. Kastrup J, Hald T, Larsen S, Nielsen VG. Histamine content and mast cell count of detrusor muscle in patients with interstitial cystitis and other types of chronic cystitis. Br J Urology. 1983;55:495–500.

    CAS  Google Scholar 

  50. Larsen S, Thompson SA, Hald T, et al. Mast cells in interstitial cystitis. Br J Urology. 1982;54:283–6.

    CAS  Google Scholar 

  51. Dasgupta P, Sharma SD, Womack C, et al. Cimetidine in painful bladder syndrome: a histopathological study. BJU Int. 2001;88:183.

    CAS  PubMed  Google Scholar 

  52. Seshadri P, Emerson L, Morales A. Cimetidine in the treatment of interstitial cystitis. Urology. 1994;44:614.

    CAS  PubMed  Google Scholar 

  53. Theoharides TC. Hydroxyzine for interstitial cystitis. J Allergy Clin Immunol. 1993;91:686–7.

    CAS  PubMed  Google Scholar 

  54. Theoharides TC. Hydroxyzine in the treatment of interstitial cystitis. Urology Clin North Am. 1994;21:113–9.

    CAS  Google Scholar 

  55. Koziol JA, Clark DC, Gittes RF, Tan EM. The natural history of interstitial cystitis: a survey of 374 patients. J Urology. 1993;149:465–9.

    CAS  Google Scholar 

  56. Theoharides TC, Sant GR, El-Mansoury M, Letourneau RJ, Ucci Jr AA, Meares Jr EM. Activation of bladder mast cells in interstitial cystitis: a light and electron microscopic study. J Urology. 1995;153:629–36.

    CAS  Google Scholar 

  57. Sant GR. Intravesical 50 % dimethyl sulfoxide (Rimso-50) in treatment of interstitial cystitis. Urology. 1987;29(Suppl):17–21.

    CAS  PubMed  Google Scholar 

  58. Theoharides TC, Sant GR. Hydroxyzine therapy for interstitial cystitis. Urology. 1997;49:108.

    CAS  PubMed  Google Scholar 

  59. Letourneau R, Pang X, Sant GR, et al. Intragranular activation of bladder mast cells and their association with nerve processes in interstitial cystitis. Br J Urology. 1996;77:41.

    CAS  Google Scholar 

  60. Moran PA, Dwyer PL, Carey MP, et al. Oral methotrexate in the management of refractory interstitial cystitis. Aust N Z J Obstet Gynaecol. 1999;39:468.

    CAS  PubMed  Google Scholar 

  61. Oravisto KJ and Alfthan OS: Treatment of interstitial cystitis with immunosuppression and chloroquine derivatives. Eur Urology 1976; 82.

  62. Van de Merwe J, Kamerling R, Arendsen E, Mulder D, Hooijkass HJ. Sjogren’s Syndrome in patients with interstitial cystitis. Acta Rhematol. 1993;20:962–6.

    Google Scholar 

  63. Alagiri M, Chottiner S, Ratner V, et al. Interstitial cystitis: unexplained associations with other chronic disease and pain syndromes. Urology. 1997;49:52.

    CAS  PubMed  Google Scholar 

  64. Ogawa H, Kameda H, Amano K, et al. Efficacy and safety of cyclosporine A in patients with refractory systemic lupus erythematosus in a daily clinical practice. Lupus. 2010;19:162.

    CAS  PubMed  Google Scholar 

  65. Sairanen J, Tammela TL, Leppilahti M, et al. Cyclosporine A and pentosan polysulfate sodium for the treatment of interstitial cystitis: a randomized comparative study. J Urology. 2005;174:2235.

    CAS  Google Scholar 

  66. Forrest JB, Payne CK, Erickson DR. Cyclosporin A for refractory interstitial cystitis/Bladder pain syndrome: experience of 3 tertiary centers. J Urology. 2012;188(4):1186–91.

    CAS  Google Scholar 

  67. Thorne JE, Jabs DA, Qazi FA, et al. Mycophenolate mofetil therapy for inflammatory eye disease. Ophthalmology. 2005;112:1472.

    PubMed  Google Scholar 

  68. Pisoni CN, Sanchez FJ, Karim Y, et al. Mycophenolate mofetil in systemic lupus erythematosus: efficacy and tolerability in 86 patients. J Rheumatol. 2005;32:1047.

    CAS  PubMed  Google Scholar 

  69. Kapitsinou PP, Boletis JN, Skopouli FN, et al. Lupus nephritis: treatment with mycophenolate mofetil. Rheumatology (Oxford). 2004;43:377.

    CAS  Google Scholar 

  70. Van de Merwe JP. Interstitial cystitis and systemic autoimmune disease. Nat Clin Pract Urology. 2007;4:484.

    Google Scholar 

  71. Boye E, Morse M, Huttner I, Erlanger BF, McKinnon KJ, Klassen J. Immune complex-mediated interstitial cystitis as a major manifestation of systemic lupus erythematosus. Clin Immunol Immunopathol. 1979;13:67–76.

    CAS  PubMed  Google Scholar 

  72. Yang CC, Burks DA, Nyberg LM, et al. Early termination of a trial of mycophenolate mofetil for treatment of intersitital cystitis/painful bladder syndrome: lessons learned. J Urology. 2011;185(3):901–6.

    Google Scholar 

  73. Delafoy L, Raymond F, Doherty AM, et al. Role of nerve growth factor in the trinitrobenzene sulfonic acid-induced colonic hypersensitivity. Pain. 2003;105:489.

    CAS  PubMed  Google Scholar 

  74. Jaggar SI, Scott HC, Rice AS. Inflammation of the rat urinary bladder is associated with a referred thermal hyperalgesia which is nerve growth factor dependent. Br J Anaesth. 1999;83:442.

    CAS  PubMed  Google Scholar 

  75. Liu HT, Kuo HC. Increased urine and serum nerve growth factor levels in interstitial cystitis suggest chronic inflammation is involved in the pathogenesis of disease. PLoS One. 2012;7(9):e44687.

    CAS  PubMed Central  PubMed  Google Scholar 

  76. Evans RJ, Moldwin RM, Cossons N, Darekar A, Mills IW, Scholfied D. Proof of concept trail of Tanezumab for the treatment of symptoms associated with interstitial cystitis. J Urology. 2011;185(5):1716–21. andomized, double-blind, placebo-controlled phase 2 clinical trial investigating tanezumab, a humanized monoclonal antibody that specifically inhibits nerve growth factor, as a treatment of IC/PBS. The study demonstrated a statistically significant decrease in daily pain score and improvement in global response assessment.

    CAS  Google Scholar 

  77. Parsons CL, Housley T, Schmidt JD, et al. Treatment of interstitial cystitis with intravesical heparin. Br J Urology. 1994;73:504–7.

    CAS  Google Scholar 

  78. Moldwin RM, Sant GR. Interstitial cystitis: a pathophysiology and treatment update. Clin Obstet Gynecol. 2002;45:259–72.

    PubMed  Google Scholar 

  79. Lose G, Frandsen B, Hojensgard JC, Jesperasan, Astrup T. Chronic interstitial cystitis. Increased levels of eosinophil cationic protein in serum and urine and an ameliorating effect of subcutaneous heparin. Scand J Urology Nephrol. 1983;17:159–61.

    CAS  Google Scholar 

  80. Lose G, Jerpersen J, Frandsen B, Hojensgrad JC, Astrup T. Subcutaneous heparin in the treatment of interstitial cystitis. Scan J Urology Nephrol. 1985;19:27–9.

    CAS  Google Scholar 

  81. Henry R, Patterson L, Avery N, et al. Absorption of alkalized intravesical lidocaine in normal and inflamed bladders: a simple method for improving bladder anesthesia. J Urology. 2001;165:1900–3.

    CAS  Google Scholar 

  82. Parsons CL. Successful downregulation of bladder sensory nerves with combination of heparin and alkalinized lidocaine in patients with interstitial cystitis. Urology. 2005;65(1):45–8.

    PubMed  Google Scholar 

  83. Welk BK, Teichman JM. Dyspareunia response in patients with interstitial cystitis treated with intravesical lidocaine, bicarbonate, and heparin. Urology. 2008;71(1):67–70.

    PubMed  Google Scholar 

  84. 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 Urology. 2013.

  85. Jacob SW, Bischel M, Herschler RJ. Dimethyl sulfoxide (DSMO): A new concept in pharmacotherapy. Curr Ther Res. 1964;6:134–5.

    CAS  PubMed  Google Scholar 

  86. Perez-Marrero R, Emerson LE, Feltis JT. A controlled study of dimethyl sulfoxide in interstitial cystitis. J Urology. 1988;140(1):36–9.

    CAS  Google Scholar 

  87. Parkin J, Shea C, Sant GR. Intravesical dimethyl sulfoxide (DMSO) for interstitial cystitis—a practical approach. Urology. 1997;49(5A Suppl):105–7.

    CAS  PubMed  Google Scholar 

  88. Biggers RD. Self-administration of dimethyl sulfoxide (DMSO) for interstitial cystitis. Urology. 1986;28:10–1.

    CAS  PubMed  Google Scholar 

  89. Stav K, Beberashvili I, Lindner A, Leibovici D. Predictors of response to intravesical dimethyl-sulfoxide cocktail in patients with interstitial cystitis. Urology. 2012;80(1):61–5. A prospective trial of patients receiving intravesical DMSO, hydrocortisone, heparin and bupivacaine for 12 weeks. This study demonstrated patient age, menopausal status, BMI, diabetes mellitus, and cystometric bladder capacity were associated with clinical response to this intravesical cocktail. Anesthetic bladder capacity <675 mL was the only independent predictor of treatment failure in this study.

    PubMed  Google Scholar 

  90. Hung MJ, Chen YT, Shen PS, Hsu ST, Chen GD, Ho ES. Risk factors that affect the treatment of interstitial cystitis using intravesical therapy with a dimethyl sulfoxide cocktail. Int Urogynecol J. 2012;23(11):1533–9.

    PubMed  Google Scholar 

  91. Al Hadithi H, Tincello DG, Vince GS, Richmond DH. Leukocyte populations in interstitial cystitis and idiopathic reduced bladder storage. Urology. 2002;59:851–5.

    PubMed  Google Scholar 

  92. Tissot WD, Diokno AC, Peters KM. A referral center’s experience with transitional cell carcinoma misdiagnosed as interstitial cystitis. J Urology. 2004;172:478–80.

    Google Scholar 

  93. Cole EE, Scarpero HM, Dmochowski RR. Are patient symptoms predictive of the diagnostic and/or therapeutic value of hydrodistention? Neurourol Urodyn. 2005;24:638.

    PubMed  Google Scholar 

  94. Erickson DR, Kunselman AR, Bentley CM, et al. Changes in urine markers and symptoms after bladder distention for interstitial cystitis. J Urology. 2007;177:556.

    Google Scholar 

  95. Ottem DP, Teichman JM. What is the value of cystoscopy with hydrodistension for interstitial cystitis? Urology. 2005;66:494.

    PubMed  Google Scholar 

  96. Aihara K, Hirayama A, Tanaka N, Fujimoto K, Yoshida K, Hirao Y. Hydrodistension under local anesthesia for patients with suspected painful bladder syndrome/interstitial cystitis: safety, diagnostic potential and therapeutic efficacy. Int J Urology. 2009;16(12):947–52.

    Google Scholar 

  97. McCahy PJ, Styles RA. Prolonged bladder distension: experience in the treatment of detrusor overactivity and interstitial cystitis. Eur Urology. 1995;28:325.

    CAS  Google Scholar 

  98. Glemain P, Riviere C, Lenormand L, et al. Prolonged hydrodistention of the bladder for symptomatic treatment of interstitial cystitis: efficacy at 6 months and 1 year. Eur Urology. 2002;41:79.

    Google Scholar 

  99. Faraday M, Hubbard H, Kosiak B, et al. Staying at the Cutting Edge: a review and analysis of evidence reporting and grading: the recommendations of the American Urological Association. Br J Urology-Int. 2009;104:294.

    Google Scholar 

  100. Hillelsohn JH, Rais-Bahrami S, Friedlander JI, Okhunov Z, Kashan M, Rose L, et al. Fulguration for Hunner Ulcers: Long-Term Clinical Outcomes. J Urology. 2012;188(6):2238–41.

    Google Scholar 

  101. Rofeim O, Hom D, Freid RM, et al. Use of the neodymium: YAG laser for interstitial cystitis: a prospective study. J Urology. 2001;166:134.

    CAS  Google Scholar 

  102. Cox M, Klutke JJ, Kutlke CG. Assess-ment of patient outcomes following sub-musocal injection if triamcinolone for treatment of Hunner’s ulcer subtype in-terstitial cystitis. Can J Urology. 2009;16:4536.

    Google Scholar 

  103. Schurch B, Schmid DM, Stöhrer M. Treatment of neurogenic incontinence with botulinum toxin A. N Engl J Med. 2000;342:665.

    CAS  PubMed  Google Scholar 

  104. Tirumur S, Al-Kurdi D, Latthe P. Intravesical botulinum toxin A injections in the treatment of painful bladder syndrome/interstitial cystitis: a systematic review. Int Urogynecol J. 2010;21:1285–300.

    Google Scholar 

  105. Lucioni A, Bales GT, Lotan TL, McGehee DS, Cook SP, Rapp DE. Botulinum toxin type A inhibits sensory neuropeptide release in rat bladder models of acute and chronic inflammation. BJU Int. 2008;101:366–70.

    CAS  PubMed  Google Scholar 

  106. Kuo HC, Chancellor MB. Comparison of intravesical botulinum toxin type A injections plus hydrodistention with hydrodistention alone for the treatment of refractory interstitial cystitis/painful bladder syndrome. BJU. 2009;104(5):657–61.

    CAS  Google Scholar 

  107. Gottsh HP, Miller JL, Yang CC, Berger RE. A pilot study of botulinum toxin for interstitial cystitis/painful bladder syndrome. Neurourol Urodynam. 2011;30:93–6.

    Google Scholar 

  108. Shie JH, Liu HT, Wang YS, Kuo HC. Immunohistochemical evidence suggests repeated intravesical application of botulinum toxin A injections may improve treatment efficacy of interstitial cystitis/bladder pain syndrome. BJU Int. 2013;111(4):638–46. his clinical trial demonstrated both histological and clinical evidence of positive response to repeated intravesical injections of BTX-A in IC/PBS patients.

    CAS  PubMed  Google Scholar 

  109. Kuo HC. Repeated onabotulinumtoxin-a injections provide better results than single injection in treatment of painful bladder syndrome. Pain Physician. 2013;16(1):15–23.

    Google Scholar 

  110. Nickel JC. Interstitial cystitis: Characterization and management of an enigmatic urologic syndrome. Rev Urology. 2002;4:112–21.

    Google Scholar 

  111. Shaker H, Wang Y, Loung D, et al. Role of C-afferent fibres in the mechanism of action of sacral nerve root neuromodulation in chronic spinal cord injury. BJU Int. 2000;85:905–10.

    CAS  PubMed  Google Scholar 

  112. Elbadawi A. Interstitial cystitis: a critique of current concepts with a new proposal for pathologic diagnosis and pathogenesis. Urology. 1997;49(suppl):14.

    CAS  PubMed  Google Scholar 

  113. Siegel S, Paszkiewicz E, Kirkpatrick C, et al. Sacral nerve stimulation in patients with chronic intractable pelvic pain. J Urology. 2001;166:1742–5.

    CAS  Google Scholar 

  114. Comiter CV. Sacral neuromodulation for the symptomatic treatment of refractory interstitial cystitis: a prospective study. J Urology. 2003;169:1369–73.

    Google Scholar 

  115. Zabihi N, Mourtzinos A, Maher MG, Raz S, Rodríguez LV. Short-term results of bilateral S2-S4 Sacral Neuromodulation for the treatment of refractory interstitial cystitis, painful bladder syndrome, and chronic pelvic pain. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19:553–7.

    PubMed  Google Scholar 

  116. Ghazwani YQ, Elkelini MS, Hassouna MM. Efficacy of sacral neuromodulation in treatment of bladder pain syndrome: long-term follow-up. Neurourol Urodyn. 2011;30(7):1271–5.

    PubMed  Google Scholar 

  117. Gajewski JB, Al-Zahrani AA. The long-term efficacy of sacral neuromodulation in the management of intractable cases of bladder pain syndrome: 14 years of experience in one centre. BJU Int. 2011;107(8):1258–64.

    PubMed  Google Scholar 

  118. Gokyildiz S, Kizilkaya Beji N, Yalcin O, Istek A. Effects of percutaneous tibial nerve stimulation therapy on chronic pelvic pain. Gynecol Obstet Invest. 2012;73(2):99–105.

    PubMed  Google Scholar 

  119. O'Reilly BA, Dwyer PL, Hawthorne G, Cleaver S, Thomas E, Rosamilia A, et al. Transdermal posterior tibial nerve laser therapy is not effective in women with interstitial cystitis. J Urology. 2004;172(5 Pt 1):1880–3.

    Google Scholar 

  120. Rössberger J, Fall M, Jonsson O, Peeker R. Long-term results of reconstructive surgery in patients with bladder pain syndrome/interstitial cystitis: subtyping is imperative. Urology. 2007;70:638–42.

    PubMed  Google Scholar 

  121. Reimer K, Fleischer W, Brogmann B, et al. Povidone-iodine liposomes—an overview. Dermatology. 1997;195(suppl):93.

    PubMed  Google Scholar 

  122. Tyagi P, Wu PC, Chancellor MB, et al. Recent advances in intravesical drug/gene delivery. Molec Pharmaceut. 2006;4:369.

    Google Scholar 

  123. Fraser MO, Chuang YC, Tyagi P, et al. Intravesical liposomes administration: a novel treatment for hyperactive bladder in the rat. Urology. 2003;61:656.

    PubMed  Google Scholar 

  124. Chuang YC, Lee WC, Lee WC, Chiang PH. Intravesical liposome versus oral pentosan polysulfate for interstitial cystitis/painful bladder syndrome. J Urology. 2009;182(4):1393–400.

    CAS  Google Scholar 

  125. Lee WC, Chuang YC, Lee WC, Chiang PH. Safety and dose flexibility clinical evaluation of intravesical liposome in patients with interstitial cystitis or painful bladder syndrome. Kaohsiung J Med Sci. 2011;27(10):437–40.

    CAS  PubMed  Google Scholar 

  126. Hader JE, Marzella L, Myers RA, Jacobs SC, Naslund MJ. Hyperbaric oxygen treatment for experimental cyclophosphamide-induced hemorrhagic cystitis. J Urology. 1993;149(6):1617–21.

    CAS  Google Scholar 

  127. Weiss JP, Mattei DM, Neville EC, Hanno PM. Primary treatment of radiation-induced hemorrhagic cystitis with hyperbaric oxygen: 10-year experience. J Urology. 1994;151(6):1514–7.

    CAS  Google Scholar 

  128. Tanaka T, Nitta Y, Morimoto K, Nishikawa N, Nishihara C, Tamada S, et al. Hyperbaric oxygen therapy for painful bladder syndrome/interstitial cystitis resistant to conventional treatments: long-term results of a case series in Japan. BMC Urol. 2011;11:11. A case series of 11 patients with refractory IC/PBS. All patients had failed conventional therapy. Treatment led to decrease in pelvic pain and urgency scales in the majority of patients.

    CAS  PubMed Central  PubMed  Google Scholar 

  129. Gallego-Vilar D, García-Fadrique G, Povo-Martin I, Salvador-Marin M, Gallego-Gomez J. Maintenance of the response to dimethyl sulfoxide treatment using hyperbaric oxygen in interstitial cystitis/painful bladder syndrome: a prospective, randomized, comparative study. Urology Int. 2013;90(4):411–6.

    CAS  Google Scholar 

Download references

Compliance with Ethics Guidelines

ᅟ

Conflict of Interest

Dr. Anthony J. Dyer declares no potential conflicts of interest relevant to this article.

Dr. Christian O. Twiss received payment for development of educational presentations including service on speakers' bureaus from Allergan, Inc.

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.

Author information

Authors and Affiliations

  1. Department of Surgery, Section of Urology, University of Arizona Medical Center, 1501 N. Campbell Avenue, P.O. BOX 245077, Tucson, AZ, 85724-5077, USA

    Anthony J. Dyer

  2. Director of Female Urology, Pelvic Medicine, and Pelvic Reconstructive Surgery, Department of Surgery, Section of Urology, University of Arizona Medical Center, 1501 N. Campbell Avenue, P.O. BOX 245077, Tucson, AZ, 85724-5077, USA

    Christian O. Twiss

Authors
  1. Anthony J. Dyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christian O. Twiss
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christian O. Twiss.

Additional information

This article is part of the Topical Collection on Female Urology

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dyer, A.J., Twiss, C.O. Painful Bladder Syndrome: An Update and Review of Current Management Strategies. Curr Urol Rep 15, 384 (2014). https://doi.org/10.1007/s11934-013-0384-z

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11934-013-0384-z

Keywords

Search

Navigation