IC Treatment Guidelines
The need for standardized guidelines for diagnosing and treating interstitial cystitis (IC) has become very apparent over the past few years—and has generated many heated debates. The good news is that several countries and professional medical associations are now in the process of developing their own IC Guidelines.
In March 2011, the American Urological Association (AUA) released clinical guidelines including:
- A paper describing consensus from an expert panel on the recommended diagnosis and treatment approaches for IC.
- An algorithm providing a snapshot of the clinical treatment approach.
The ICA encourages patients to print copies of these documents and to give them to ALL of the members of their healthcare teams:
The AUA initially announced the release of preliminary IC guidelines at the AUA 2010 annual meeting. On behalf of the AUA's IC guidelines committee, Phil Hanno, MD, presented the first-ever guidelines for diagnosis and treatment from the association. These guidelines do not support using the potassium sensitivity test as a valid one for IC, nor do they support cystoscopy with hydrodistention under anesthesia for "uncomplicated" cases, that is, cases that are not severe and don't have many accompanying conditions. The guidelines emphasize conservative, noninvasive approaches to start, for example, an IC-friendly diet, physical therapy aimed at pelvic floor dysfunction, and stress management. Therapies called first-line treatments include the oral medicines amitriptyline, histamine blockers such as hydroxyzine (Atarax, Vistaril) or cimetidine (Tagamet), pentosan polysulfate (Elmiron) and bladder instillation therapy. Treatment recommends then step up through five levels-no matter what level, the guidelines emphasize the importance of pain management.
Dr. Hanno emphasized that these guidelines are a work in progress and far from the final word on IC diagnosis and treatment. Furthermore, the guidelines reflect what's been published so far in controlled trials or other trustworthy studies and sometimes on expert opinion, so they don't necessarily include helpful treatments that IC experts are just starting to use and research.
Check out an ICA Short with Dr. Hanno about the diagnosis and treatment guidelines.
More videos of Dr. Hanno discussing the AUA guidelines.
East Asian: An East Asian Committee, with representatives from Japan, Korea, and Taiwan, published (on the website of the International Journal of Urology) a sneak preview of Clinical Guidelines for Interstitial Cystitis and Hypersensitive Bladder Syndrome.
Indian: The launch of the Indian IC/PBS Society and intent to develop Indian Clinical Guidelines was announced at a meeting of leading IC/PBS experts in Goa, India (June 20 to 21, 2009). Under the direction of Dr. Nagendra Mishra, the Society plans to spend a year researching treatment protocols in hopes of validating country-wide treatment guidelines.
Japanese: The Japanese Urological Association’s new IC Guidelines were recently published in the International Journal of Urology. Japanese Guidelines for Diagnosis and Treatment of Interstitial Cystitis by Homma, Ueda, Ito, Takei, and Tomoe is a very detailed, comprehensive document that you can access for free online.
Revised May 8, 2013