Canadian Urologists Release Comprehensive Guideline for Care of IC/BPS
Cox A, Golda N, Nadeau G, Curtis Nickel J, Carr L, Corcos J, Teichman J. CUA guideline: Diagnosis and treatment of interstitial cystitis/bladder pain syndrome. Can Urol Assoc J. 2016 May-Jun;10(5-6):E136-E155. Epub 2016 May 12.
The Canadian Urological Association (CUA) has released comprehensive guideline for interstitial cystitis/bladder pain syndrome (IC/BPS) that includes citations from more than 200 scientific publications and covers aspects of diagnosis and treatment in detail. This guideline is based not only on current medical literature, but also on expert consensus conference proceedings. The guidelines include “grades” that correspond to the level of evidence supporting each recommendation: for example, patient education on IC/BPS gets a grade of “A” and is recommended for all patients; physiotherapy and massage gets a “B” grade and is recommended for patients with pelvic floor dysfunction; and trigger point injections only rate a “D” and are listed as an option for patients with trigger point pain. In all, the guidelines include a summary of treatment recommendations for 29 such treatment options. That summary itself could be a useful resource for physicians in Canada, where the only two officially approved treatments are pentosan polysulfate (Elmiron), which is given orally, and dimethysulfoxide (DMSO), which is administered intravesically. Most importantly, the guideline authors seek to identify the optimal therapy for different types of patients, when possible. The goal, according to the authors, is to individualize treatment plans to the specific patient, rather than follow a traditional approach where every patient gets the exact same therapy, one therapy at a time. They believe the individualized approach will yield the best patient outcomes.