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Managing Interstitial Cystitis/Bladder Pain Syndrome in Older Adults

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Abstract

In this review, the current literature regarding pharmacotherapy treatment strategies available for the management of interstitial cystitis/bladder pain syndrome in older adults is addressed. The focus is on those treatments described by the American Urologic Association guidelines, organized according to clinical phenotype. Symptoms at presentation can vary with age, with older adults being more likely to experience nocturia, urinary incontinence, and Hunner’s lesions than their younger counterparts. As such, treatment of interstitial cystitis/bladder pain syndrome should follow an individualized multimodal plan based on the patient’s unique phenotype(s), starting with the most conservative options and escalating as needed. The side-effect profile and medication interactions should be reviewed, especially when treating older adults, requesting the aid of pharmacists or the primary care physician as needed to safely provide treatment.

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References

  1. 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. 2015;193(5):1545–53.

    PubMed  Google Scholar 

  2. Hanno P, Dmochowski R. Status of international consensus on interstitial cystitis/bladder pain syndrome/painful bladder syndrome: 2008 snapshot. Neurourol Urodyn. 2009;28(4):274–86.

    PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  4. Berry SH, Elliott MN, Suttorp M, Bogart LM, Stoto MA, Eggers P, et al. Prevalence of symptoms of bladder pain syndrome/interstitial cystitis among adult females in the United States. J Urol. 2011;186(2):540–4.

    PubMed  PubMed Central  Google Scholar 

  5. Clemens JQ, Meenan RT, O’Keeffe Rosetti MC, Brown SO, Gao SY, Calhoun EA. Prevalence of interstitial cystitis symptoms in a managed care population. J Urol. 2005;174(2):576–80.

    PubMed  Google Scholar 

  6. Rais-Bahrami S, Friedlander JI, Herati AS, Sadek MA, Ruzimovsky M, Moldwin RM. Symptom profile variability of interstitial cystitis/painful bladder syndrome by age. BJU Int. 2012;109(9):1356–9.

    PubMed  Google Scholar 

  7. Richter B, Hesse U, Hansen AB, Horn T, Mortensen SO, Nordling J. Bladder pain syndrome/interstitial cystitis in a Danish population: a study using the 2008 criteria of the European Society for the Study of Interstitial Cystitis. BJU Int. 2010;105(5):660–7.

    PubMed  Google Scholar 

  8. Lee M-H, Chang K-M, Tsai W-C. Morbidity rate and medical utilization in interstitial cystitis/painful bladder syndrome. Int Urogynecol J. 2018;29(7):1045–50.

    PubMed  Google Scholar 

  9. Clemens JQ, Mullins C, Ackerman AL, Bavendam T, van Bokhoven A, Ellingson BM, et al. Urologic chronic pelvic pain syndrome: insights from the MAPP Research Network. Nat Rev Urol. 2019;16(3):187–200.

    PubMed  PubMed Central  Google Scholar 

  10. 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. 2018;25(2):9250–4.

    PubMed  Google Scholar 

  11. Andersson K-E, Boedtkjer DB, Forman A. The link between vascular dysfunction, bladder ischemia, and aging bladder dysfunction. Ther Adv Urol. 2017;9(1):11–27.

    CAS  PubMed  Google Scholar 

  12. Pinggera G-M, Mitterberger M, Pallwein L, Schuster A, Herwig R, Frauscher F, et al. Alpha-blockers improve chronic ischaemia of the lower urinary tract in patients with lower urinary tract symptoms. BJU Int. 2008;101(3):319–24.

    CAS  PubMed  Google Scholar 

  13. Nomiya M, Yamaguchi O, Andersson K-E, Sagawa K, Aikawa K, Shishido K, et al. The effect of atherosclerosis-induced chronic bladder ischemia on bladder function in the rat. Neurourol Urodyn. 2012;31(1):195–200.

    CAS  PubMed  Google Scholar 

  14. 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. 2016;10(5–6):E136–55.

    PubMed  PubMed Central  Google Scholar 

  15. 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. 2018;37(7):2271–2.

    PubMed  Google Scholar 

  16. Malde S, Palmisani S, Al-Kaisy A, Sahai A. Guideline of guidelines: bladder pain syndrome. BJU Int. 2018;122(5):729–43.

    PubMed  Google Scholar 

  17. Cesari M, Calvani R, Marzetti E. Frailty in older persons. Clin Geriatr Med. 2017;33(3):293–303.

    PubMed  Google Scholar 

  18. Morley JE, Vellas B, van Kan GA, Anker SD, Bauer JM, Bernabei R, et al. Frailty consensus: a call to action. J Am Med Dir Assoc. 2013;14(6):392–7.

    PubMed  PubMed Central  Google Scholar 

  19. Theou O, Walston J, Rockwood K. Operationalizing frailty using the frailty phenotype and deficit accumulation approaches. Interdiscip Top Gerontol Geriatr. 2015;41:66–73.

    PubMed  Google Scholar 

  20. Morley JE, Malmstrom TK, Miller DK. A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans. J Nutr Health Aging. 2012;16(7):601–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  21. Atchley MD, Shah NM, Whitmore KE. Complementary and alternative medical therapies for interstitial cystitis: an update from the United States. Transl Androl Urol. 2015;4(6):662–7.

    PubMed  PubMed Central  Google Scholar 

  22. Gordon B, Shorter B, Sarcona A, Moldwin RM. Nutritional considerations for patients with interstitial cystitis/bladder pain syndrome. J Acad Nutr Diet. 2015;115(9):1372–9.

    PubMed  Google Scholar 

  23. Cho SY, Lee SL, Kim IS, Koo DH, Kim H, Oh S-J. Short-term effects of systematized behavioral modification program for nocturia: a prospective study. Neurourol Urodyn. 2012;31(1):64–8.

    PubMed  Google Scholar 

  24. FitzGerald MP, Payne CK, Lukacz ES, Yang CC, Peters KM, Chai TC, et al. Randomized multicenter clinical trial of myofascial physical therapy in women with interstitial cystitis/painful bladder syndrome and pelvic floor tenderness. J Urol. 2012;187(6):2113–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  25. Kim A, Keyong-Ok H, Shin JH, Choo M-S. Evaluation of the incidence and risk factors associated with persistent frequency in interstitial cystitis/bladder pain syndrome and the efficacy of antimuscarinic treatment. Investig Clin Urol. 2017;58(5):353–8.

    PubMed  PubMed Central  Google Scholar 

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

    PubMed  Google Scholar 

  27. Anger J, Zabihi N, Clemens JQ, Payne CK, Saigal LVR. Treatment choice, duration, and cost in patients with interstitial cystitis and painful bladder syndrome. Int Urogynecol J. 2011;22(4):395–400.

    PubMed  Google Scholar 

  28. Suskind AM, Quanstrom K, Zhao S, Bridge M, Walter LC, Neuhaus J, et al. Overactive bladder is strongly associated with frailty in older individuals. Urology. 2017;106:26–31.

    PubMed  Google Scholar 

  29. American Geriatrics Society Beers Criteria Update Expert Panel 2019. American Geriatrics Society 2019 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2019;67(4):674–94.

    Google Scholar 

  30. Coupland CAC, Hill T, Dening T, Morriss R, Moore M, Hippisley-Cox J. Anticholinergic drug exposure and the risk of dementia. JAMA Intern Med. 2019;179(8):1084.

    PubMed Central  PubMed  Google Scholar 

  31. Green AR, Reifler LM, Bayliss EA, Weffald LA, Boyd CM. Drugs contributing to anticholinergic burden and risk of fall or fall-related injury among older adults with mild cognitive impairment, dementia and multiple chronic conditions: a retrospective cohort study. Drugs Aging. 2019;36(3):289–97.

    CAS  PubMed  PubMed Central  Google Scholar 

  32. Orme S, Morris V, Gibson W, Wagg A. Managing urinary incontinence in patients with dementia: pharmacological treatment options and considerations. Drugs Aging. 2015;32(7):559–67.

    CAS  PubMed  Google Scholar 

  33. Di Lena M, Tolls V, Kelly K-L, Nickel JC. Mirabegron as adjuvant treatment for patients with interstitial cystitis/bladder pain syndrome. Can Urol Assoc J. 2017;12(3):E100–4.

    PubMed  PubMed Central  Google Scholar 

  34. Gauthier C, Leblais V, Kobzik L, Trochu JN, Khandoudi N, Bril A, et al. The negative inotropic effect of beta3-adrenoceptor stimulation is mediated by activation of a nitric oxide synthase pathway in human ventricle. J Clin Investig. 1998;102(7):1377–84.

    CAS  PubMed  PubMed Central  Google Scholar 

  35. Kelleher C, Hakimi Z, Zur R, Siddiqui E, Maman K, Aballéa S, et al. Efficacy and tolerability of mirabegron compared with antimuscarinic monotherapy or combination therapies for overactive bladder: a systematic review and network meta-analysis. Eur Urol. 2018;74(3):324–33.

    CAS  PubMed  Google Scholar 

  36. Tadrous M, Matta R, Greaves S, Herschorn S, Mamdani MM, Juurlink DN, et al. Association of mirabegron with the risk of arrhythmia in adult patients 66 years or older: a population-based cohort study. JAMA Intern Med. 2019;179(10):1436.

    PubMed Central  PubMed  Google Scholar 

  37. Anderson VR, Perry CM. Pentosan polysulfate: a review of its use in the relief of bladder pain or discomfort in interstitial cystitis. Drugs. 2006;66(6):821–35.

    CAS  PubMed  Google Scholar 

  38. Sairanen J, Hotakainen K, Tammela TLJ, Stenman U-H, Ruutu M. Urinary epidermal growth factor and interleukin-6 levels in patients with painful bladder syndrome/interstitial cystitis treated with cyclosporine or pentosan polysulfate sodium. Urology. 2008;71(4):630–3.

    PubMed  Google Scholar 

  39. Parsons CL. Bladder surface glycosaminoglycan: efficient mechanism of environmental adaptation. Urology. 1986;27(2 Suppl.):9–14.

    CAS  PubMed  Google Scholar 

  40. 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. 1987;138(3):503–7.

    CAS  PubMed  Google Scholar 

  41. Mulholland SG, Hanno P, Parsons CL, Sant GR, Staskin. 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 

  42. 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. 1993;150(3):845–8.

    CAS  PubMed  Google Scholar 

  43. 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. 2003;170(3):810–5.

    CAS  PubMed  Google Scholar 

  44. 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. 2019;35(9):1495–503

    PubMed  Google Scholar 

  45. Pearce WA, Chen R, Jain N. Pigmentary maculopathy associated with chronic exposure to pentosan polysulfate sodium. Ophthalmology. 2018;125(11):1793–802.

    PubMed  Google Scholar 

  46. Hanif AM, Shah R, Yan J, Varghese JS, Patel SA, Cribbs BE, et al. Strength of association between pentosan polysulfate and a novel maculopathy. Ophthalmology. 2019;126(10):1464–6.

    PubMed  Google Scholar 

  47. Jain N, Li AL, Yu Y, VanderBeek BL. Association of macular disease with long-term use of pentosan polysulfate sodium: findings from a US cohort. Br J Ophthalmol. 2019;104(8):1093–7

    PubMed  Google Scholar 

  48. Ferguson TJ, Geraets RL, Barker MA. Chronic use of pentosan polysulfate sodium associated with risk of vision-threatening disease. Int Urogynecol J. 2019;30(3):337–8.

    PubMed  Google Scholar 

  49. 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. 2000;56(6):940–5.

    CAS  PubMed  Google Scholar 

  50. Aizawa N, Wyndaele J-J. Effects of phenazopyridine on rat bladder primary afferent activity, and comparison with lidocaine and acetaminophen. Neurourol Urodyn. 2010;29(8):1445–50.

    CAS  PubMed  Google Scholar 

  51. 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. 2018;12(1):E1–5.

    PubMed  Google Scholar 

  52. Singh M, Shailesh F, Tiwari U, Sharma SG, Malik B. Phenazopyridine associated acute interstitial nephritis and review of literature. Ren Fail. 2014;36(5):804–7.

    CAS  PubMed  Google Scholar 

  53. Sant GR, LaRock DR. Standard intravesical therapies for interstitial cystitis. Urol Clin N Am. 1994;21(1):73–83.

    CAS  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  55. 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. 2017;43(1):134–41.

    PubMed  PubMed Central  Google Scholar 

  56. 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. 2017;36(4):1178–86.

    CAS  PubMed  Google Scholar 

  57. Iyer S, Lotsof E, Zhou Y, Tran A, Botros C, Sand P, et al. Which bladder instillations are more effective? DMSO vs. bupivacaine/heparin/triamcinolone: a retrospective study. Int Urogynecol J. 2017;28(9):1335–40.

    PubMed  Google Scholar 

  58. Rawls WF, Cox L, Rovner ES. Dimethyl sulfoxide (DMSO) as intravesical therapy for interstitial cystitis/bladder pain syndrome: a review. Neurourol Urodyn. 2017;36(7):1677–84.

    PubMed  Google Scholar 

  59. Chintea CL, Belal M. Is there enough evidence for the use of intravesical instillations of glycosaminoglycan analogues in interstitial cystitis? BJU Int. 2013;111(2):192–3.

    PubMed  Google Scholar 

  60. 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. 2016;27(8):1137–47.

    PubMed  Google Scholar 

  61. 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. 2010;76(4):804–9.

    PubMed  Google Scholar 

  62. 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. 2012;79(6):1220–4.

    PubMed  Google Scholar 

  63. 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. 2013;7(5–6):195–200.

    PubMed  PubMed Central  Google Scholar 

  64. Hanno PM, Parsons CL, Shrom SH, Fritz R, Mulholland SG. The protective effect of heparin in experimental bladder infection. J Surg Res. 1978;25(4):324–9.

    CAS  PubMed  Google Scholar 

  65. 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. 2012;9(1):207–12.

    CAS  PubMed  Google Scholar 

  66. Perez-Marrero R, Emerson LE, Maharajh DO, Juma S. Prolongation of response to DMSO by heparin maintenance. Urology. 1993;41(1 Suppl.):64–6.

    CAS  PubMed  Google Scholar 

  67. Meng E, Hsu Y-C, Chuang Y-C. Advances in intravesical therapy for bladder pain syndrome (BPS)/interstitial cystitis (IC). Low Urin Tract Symptoms. 2018;10(1):3–11.

    CAS  PubMed  Google Scholar 

  68. Chuang Y-C, Yoshimura N, Huang C-C, Chiang P-H, Chancellor MB. Intravesical botulinum toxin A administration produces analgesia against acetic acid induced bladder pain responses in rats. J Urol. 2004;172(4 Part 1):1529–32.

    CAS  PubMed  Google Scholar 

  69. Rapp DE, Turk KW, Bales GT, Cook SP. Botulinum toxin type A inhibits calcitonin gene-related peptide release from isolated rat bladder. J Urol. 2006;175(3):1138–42.

    CAS  PubMed  Google Scholar 

  70. Lee B-J, Jeong J-H, Wang S-G, Lee J-C, Goh E-K, Kim H-W. Effect of botulinum toxin type A on a rat surgical wound model. Clin Exp Otorhinolaryngol. 2009;2(1):20.

    PubMed  PubMed Central  Google Scholar 

  71. 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 injury and chronic inflammation. BJU Int. 2008;101(3):366–70.

    CAS  PubMed  Google Scholar 

  72. Pang X, Marchand J, Sant GR, Kream RM, Theoharides TC. Increased number of substance P positive nerve fibres in interstitial cystitis. Br J Urol. 1995;75(6):744–50.

    CAS  PubMed  Google Scholar 

  73. Smith CP, Radziszewski P, Borkowski A, Somogyi GT, Boone TB, Chancellor MB. Botulinum toxin a has antinociceptive effects in treating interstitial cystitis. Urology. 2004;64(5):871–5.

    PubMed  Google Scholar 

  74. Kuo H-C, 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 Int. 2009;104(5):657–61.

    CAS  PubMed  Google Scholar 

  75. Kuo H-C. 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 

  76. Jhang J-F, Jiang Y-H, Kuo H-C. Potential therapeutic effect of intravesical botulinum toxin type A on bladder pain syndrome/interstitial cystitis. Int J Urol. 2014;21:49–55.

    CAS  PubMed  Google Scholar 

  77. Przydacz M, Golabek T, Chlosta P. How to assess and predict success or failure of intra-detrusor injections with onabotulinumtoxinA. Adv Clin Exp Med. 2019;28(4):555–67.

    PubMed  Google Scholar 

  78. Liao C-H, Wang C-C, Jiang Y-H. Intravesical onabotulinumtoxinA injection for overactive bladder patients with frailty, medical comorbidities or prior lower urinary tract surgery. Toxins (Basel). 2016;8(4):91.

    Google Scholar 

  79. Suskind AM, Kowalik C, Quanstrom K, Boscardin J, Zhao S, Reynolds WS, et al. The impact of frailty on treatment for overactive bladder in older adults. Neurourol Urodyn. 2019;38(7):1915–23.

    CAS  PubMed  PubMed Central  Google Scholar 

  80. Jiang Y-H, Liao C-H, Tang D-L, Kuo H-C. Efficacy and safety of intravesical onabotulinumtoxinA injection on elderly patients with chronic central nervous system lesions and overactive bladder. PLoS One. 2014;9(8):e105989.

    PubMed  PubMed Central  Google Scholar 

  81. Tanne JH. FDA adds “black box” warning label to fluoroquinolone antibiotics. BMJ. 2008;337:a816.

    PubMed  Google Scholar 

  82. Gardella B, Iacobone AD, Porru D, Musacchi V, Dominoni M, Tinelli C, et al. Effect of local estrogen therapy (LET) on urinary and sexual symptoms in premenopausal women with interstitial cystitis/bladder pain syndrome (IC/BPS). Gynecol Endocrinol. 2015;31(10):828–32.

    CAS  PubMed  Google Scholar 

  83. La Rosa VL, Ciebiera M, Lin L-T, Fan S, Butticè S, Sathyapalan T, et al. Treatment of genitourinary syndrome of menopause: the potential effects of intravaginal ultralow-concentration oestriol and intravaginal dehydroepiandrosterone on quality of life and sexual function. Menopause Rev. 2019;18(2):116–22.

    Google Scholar 

  84. Patnaik SS, Laganà AS, Vitale SG, Butticè S, Noventa M, Gizzo S, et al. Etiology, pathophysiology and biomarkers of interstitial cystitis/painful bladder syndrome. Arch Gynecol Obstet. 2017;295(6):1341–59.

    CAS  PubMed  Google Scholar 

  85. Rahn DD, Carberry C, Sanses TV, Mamik MM, Ward RM, Meriwether KV, et al. Vaginal estrogen for genitourinary syndrome of menopause: a systematic review. Obstet Gynecol. 2014;124(6):1147–56.

    CAS  PubMed  PubMed Central  Google Scholar 

  86. Peeker R, Enerbäck L, Fall M, Aldenborg F. Recruitment, distribution and phenotypes of mast cells in interstitial cystitis. J Urol. 2000;163(3):1009–15.

    CAS  PubMed  Google Scholar 

  87. Theoharides TC. Hydroxyzine for interstitial cystitis. J Allergy Clin Immunol. 1993;91(2):686–7.

    CAS  PubMed  Google Scholar 

  88. Theoharides TC. Hydroxyzine in the treatment of interstitial cystitis. Urol Clin N Am. 1994;21(1):113–9.

    CAS  Google Scholar 

  89. Theoharides TC, Sant GR. Hydroxyzine therapy for interstitial cystitis. Urology. 1997;49(5A Suppl.):108–10.

    CAS  PubMed  Google Scholar 

  90. Northstart RxLLC. Hydroxyzine [package insert]. DailyMed. 2020.http://dailymed.nlm.nih.gov/dailymed/druginfo.cfm?setid=8e5fce17-936e-46ea-a969-518c952c2091. Accessed 24 Sept 2020.

  91. Simons KJ, Watson WTA, Chen XY, Simons FER. Pharmacokinetic and pharmacodynamic studies of the H1-receptor antagonist hydroxyzine in the elderly. Clin Pharmacol Ther. 1989;45(1):9–14.

    CAS  PubMed  Google Scholar 

  92. Meares EM. Interstitial cystitis: 1987. Urology. 1987;29(4 Suppl.):46–8.

    PubMed  Google Scholar 

  93. 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. 2001;87(3):207–12.

    CAS  PubMed  Google Scholar 

  94. Dasgupta P, Sharma SD, Womack C, Blackford HN, Dennis P. Cimetidine in painful bladder syndrome: a histopathological study. BJU Int. 2001;88(3):183–6.

    CAS  PubMed  Google Scholar 

  95. Lewi H. Cimetidine in treatment of interstitial cystitis. Urology. 1995;45(6):1088.

    CAS  PubMed  Google Scholar 

  96. Seshadri P, Emerson L, Morales A. Cimetidine in the treatment of interstitial cystitis. Urology. 1994;44(4):614–6.

    CAS  PubMed  Google Scholar 

  97. Mylan Pharmaceuticals Inc. Cimetidine [package insert]. DailyMed. 2020.https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=06c0a509-026f-44e0-9975-a94a8de51d43. Accessed 13 Oct 2020.

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

    PubMed  Google Scholar 

  99. Vij M, Srikrishna S, Cardozo L. Interstitial cystitis: diagnosis and management. Eur J Obstet Gynecol Reprod Biol. 2012;161(1):1–7.

    PubMed  Google Scholar 

  100. 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. 2010;183(5):1853–8.

    PubMed  PubMed Central  Google Scholar 

  101. 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. 2004;172(2):533–6.

    PubMed  Google Scholar 

  102. van Ophoven A, Hertle L. Long-term results of amitriptyline treatment for interstitial cystitis. J Urol. 2005;174(5):1837–40.

    PubMed  Google Scholar 

  103. Cutler NR, Narang PK. Implications of dosing tricyclic antidepressants and benzodiazepines in geriatrics. Psychiatr Clin N Am. 1984;7(4):845–61.

    CAS  Google Scholar 

  104. Sasaki K, Smith CP, Chuang YC, Lee JY, Kim JC, Chancellor MB. Oral gabapentin (neurontin) treatment of refractory genitourinary tract pain. Tech Urol. 2001;7(1):47–9.

    CAS  PubMed  Google Scholar 

  105. 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. 2013;17(2):78–82.

    PubMed  PubMed Central  Google Scholar 

  106. Chua ME, See MC, Esmeňa EB, Balingit JC, Morales ML. Efficacy and safety of gabapentin in comparison to solifenacin succinate in adult overactive bladder treatment. Low Urin Tract Symptoms. 2018;10(2):135–42.

    CAS  PubMed  Google Scholar 

  107. Moore RA, Wiffen PJ, Derry S, Rice AS. Gabapentin for chronic neuropathic pain and fibromyalgia in adults. In: Moore RA, editor. Cochrane database of systematic reviews. Chichester: Wiley; 2014.

    Google Scholar 

  108. Akiyama Y, Hanno P. Phenotyping of interstitial cystitis/bladder pain syndrome. Int J Urol. 2019;26(S1):17–9.

    PubMed  Google Scholar 

  109. Crescenze IM, Gupta P, Adams G, Oldendorf A, Stoffel JT, Romo PGB, et al. Advanced management of patients with ulcerative interstitial cystitis/bladder pain syndrome. Urology. 2019;133:78–83.

    PubMed  Google Scholar 

  110. Cox M, John KJ, Carl KG. Assessment of patient outcomes following submucosal injection of triamcinolone for treatment of Hunner’s ulcer subtype interstitial cystitis. Can J Urol. 2009;16(2):4536–5440.

    PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  112. 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. 2005;174(6):2235–8.

    CAS  PubMed  Google Scholar 

  113. 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. 2013;47(6):503–8.

    PubMed  Google Scholar 

  114. Forsell T, Ruutu M, Isoniemi H, Ahonen J, Alfthan O. Cyclosporine in severe interstitial cystitis. J Urol. 1996;155(5):1591–3.

    CAS  PubMed  Google Scholar 

  115. Sairanen J, Forsell T, Ruutu M. Long-term outcome of patients with interstitial cystitis treated with low dose cyclosporine A. J Urol. 2004;171(6 Pt 1):2138–41.

    CAS  PubMed  Google Scholar 

  116. Larish AM, Dickson RR, Kudgus RA, McGovern RM, Reid JM, Hooten WM, et al. Vaginal diazepam for nonrelaxing pelvic floor dysfunction: the pharmacokinetic profile. J Sex Med. 2019;16(6):763–6.

    PubMed  Google Scholar 

  117. 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. 2010;21(7):895–9.

    PubMed  Google Scholar 

  118. Bartley J, Han E, Gupta P, Gaines N, Killinger KA, Boura JA, et al. Transvaginal trigger point injections improve pain scores in women with pelvic floor hypertonicity and pelvic pain conditions. Female Pelvic Med Reconstr Surg. 2019;25(5):392–6.

    PubMed  Google Scholar 

  119. Steers WD, Tuttle JB. Mechanisms of disease: the role of nerve growth factor in the pathophysiology of bladder disorders. Nat Clin Pract Urol. 2006;3(2):101–10.

    CAS  PubMed  Google Scholar 

  120. 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. 2011;185(5):1716–21.

    CAS  PubMed  Google Scholar 

  121. 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. 2016;195(4 Pt 1):942–8.

    CAS  PubMed  Google Scholar 

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  1. Department of Urology, University of Michigan, 1500 E. Medical Center Drive, TC 3875 SPC 5330, Ann Arbor, MI, 48109, USA

    Alyssa Gracely & Anne P. Cameron

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  1. Alyssa Gracely
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Drs Gracely and Cameron both participated in the literature search and in the writing and final review of this manuscript.

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Alyssa Gracely has no conflicts of interest that are directly relevant to the content of this article. Anne P. Cameron is a PI for Medtronic and a speaker for Wellspect.

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Gracely, A., Cameron, A.P. Managing Interstitial Cystitis/Bladder Pain Syndrome in Older Adults. Drugs Aging 38, 1–16 (2021). https://doi.org/10.1007/s40266-020-00810-w

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