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Standardized Treatment for IC/BPS Remains Elusive

Pazin C, de Souza Mitidieri AM, Silva AP, Gurian MB, Poli-Neto OB, Rosa-E-Silva JC. Treatment of bladder pain syndrome and interstitial cystitis: a systematic review. Int Urogynecol J. 2015 Aug 14. [Epub ahead of print]

While there are many potential treatments for interstitial cystitis/bladder pain syndrome (IC/BPS), there is still a lack of standardized treatment. To address this, investigators attempted to analyze and compare different types of treatments based on published reports on the effectiveness of those treatments in women with IC/BPS. Out of hundreds of studies that they found, they narrowed down their analysis to just 13 trials that were randomized and controlled (i.e., the highest quality, most scientifically rigorous studies out of the group). The treatment methods described in these studies were quite varied, and included botulinum toxin A, hyaluronic acid instillation, intravesical lidocaine, massage, hyperbaric chamber, physiotherapy, phosphate-buffered saline, and piroxicam combined with doxepin, among other modalities. Notably, the investigators were unable to identify a treatment that had more than one single randomized, controlled trial showing its efficacy. The researchers concluded that, due to this limited evidence base, they were unable to define the best approach for treatment of IC/BPS. To address this, they called upon researchers to initiate studies with better methodological quality in the future.