[Specific treatments for painful bladder syndrome].
BACKGROUND
Painful bladder syndrome is defined as chronic pelvic pain present for more than 6 months, causing discomfort perceived as being related to the bladder and accompanied by a persistent and strong urge to urinate or urinary frequency. The purpose of this article is to review the treatment of painful bladder syndrome.


METHODS
A comprehensive review of the literature was performed by searching PUBMED for articles on specific treatments for painful bladder syndrome.


RESULTS
Many treatments have been proposed for the management of painful bladder syndrome: local intravesical treatments (glucosaminoglycan [pentosan polysulfate], dimethylsulfoxide [DMSO], heparin, bacillus Calmette-Guérin [BCG], anticholinergic agents [oxybutynin, etc.] or oral treatments [glucosaminoglycan (pentosan polysulfate), antihistamines, antidepressants, immunosuppressives, etc.]) with an action on the pathophysiology of this syndrome. The efficacy of these various treatments has been limited, with trials based on small numbers of patients and not always conducted according to a randomized, prospective design. Other salvage treatments (neuromodulation, botulinum toxin, surgery, etc.) have also been reported with limited efficacy, but allowing salvage of treatment failures.


CONCLUSIONS
The therapeutic management of painful bladder syndrome is complex. The large number of proposed treatment modalities present a limited efficacy with discordant results from one study to another making comparisons and analyses difficult.
Clinique urologique, centre fédératif de pelvipérinéologie, hôpital Hôtel Dieu, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France. jrigaud@chu-nantes.fr
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J
Rigaud
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Delavierre
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L
Sibert
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JJ
Labat
D000283:Administration, Intravesical; D000284:Administration, Oral; D018856:Cystitis, Interstitial / Q000188:drug therapy / Q000628:therapy*; D006801:Humans