[Intravesical therapy of interstitial cystitis].
Intravesically applied medications have the benefit of establishing high concentrations of a therapeutic agent at the intended target tissue along with a low risk for systemic side effects. Pentosanpolysulfate is frequently applied for this purpose and was shown to significantly reduce nycturia while frequency during the day remained unaffected in a controlled study. Heparin reduced nycturia in an open prospective protocol as well. For heparin the maximal onset of a therapeutic effect is often observed as late as 4-6 months after initiation of treatment. Heparin as well as pentosanpolysulfate cause practically no side effects. Dimethylsulfoxide (DMSO), when instilled intravesically, decreases symptoms up to 50-70% for an effective period of 1-2 months. An irritating but harmless side effect of DMSO is the development of a striking garlic-like odor. BCG improved symptoms in 10 of 15 patients after 8 months and in 8 of 15 patients after 24 months. No patient with an initial bladder capacity below 175 cc benefited from BCG instillations. Discomfort in the bladder region was noted as a frequent side effect. Instillations of clorpactin WCS 90 are painful and can thus only be applied under anesthesia. Success rates range between 50-70% and last for 6-12 months.
von Heyden
B
B
Klinik und Poliklinik für Urologie, Westfälische Wilhelms-Universität Münster.
Schmid
H P
HP
D000283:Administration, Intravesical; D018856:Cystitis, Interstitial / Q000188:drug therapy* / Q000209:etiology; D004121:Dimethyl Sulfoxide / Q000008:administration & dosage; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D010426:Pentosan Sulfuric Polyester / Q000008:administration & dosage; D016896:Treatment Outcome
D010426:Pentosan Sulfuric Polyester; D006493:Heparin; D004121:Dimethyl Sulfoxide