title: Alkalinized lidocaine and heparin provide immediate relief of pain and urgency in patients with interstitial cystitis.
abstract: BACKGROUND
  It has been reported in an open-label study that the combination of alkalinized lidocaine and heparin can immediately relieve the symptoms of urinary urgency, frequency, and pain associated with interstitial cystitis (IC). This combination has also been reported to relieve pain associated with sex in patients with IC.
  
  
  OBJECTIVE
  The aim of this study was to corroborate these findings in a multicenter setting.
  
  
  METHODS
  The study design was a multicenter prospective, double-blind, crossover, placebo-controlled trial. Each participant met all of the clinical National Institute of Diabetes and Digestive and Kidney Diseases criteria (excluding cystoscopy) for IC. Each patient received drug and control, in random order, within 48 hours of enrolling in the study.
  
  
  METHODS
  The primary outcome measure was percent change in pain score (11-point analog pain scale) 12 hours after receiving the drug or control. Secondary measures were the global assessment response (GAR) of symptoms and 12-hour average urgency reduction determined from 11-point urgency scales.
  
  
  RESULTS
  Eighteen (18) patients completed the trial. The average reduction of pain over 12 hours was 21% for control and 42% for active drug (P = 0.0363). GAR was 13% for control and 50% for drug (P = 0.0137). Average urgency reduction was 13% for control and 35% for drug (P = 0.0328).
  
  
  CONCLUSIONS
  The combination of alkalinized lidocaine and heparin provides up to 12 hours of relief from urgency and pain associated with IC. This combination provides significant immediate relief of symptoms for patients with IC.
authors.affiliation: Division of Urology, University of California San Diego, San Diego, CA 92103, USA. cparsons@ucsd.edu
authors.forename: C Lowell
authors.initials: CL
authors.lastname: Parsons
authors.forename: Paul
authors.initials: P
authors.lastname: Zupkas
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Proctor
authors.forename: James
authors.initials: J
authors.lastname: Koziol
authors.forename: Amie
authors.initials: A
authors.lastname: Franklin
authors.forename: Dennis
authors.initials: D
authors.lastname: Giesing
authors.forename: Edward
authors.initials: E
authors.lastname: Davis
authors.forename: Charles M
authors.initials: CM
authors.lastname: Lakin
authors.forename: Bruce S
authors.initials: BS
authors.lastname: Kahn
authors.forename: William J
authors.initials: WJ
authors.lastname: Garner
mesh_terms: D000283:Administration, Intravesical; D018592:Cross-Over Studies; D018856:Cystitis, Interstitial / Q000150:complications / Q000188:drug therapy*; D004311:Double-Blind Method; D004338:Drug Combinations; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement; D016896:Treatment Outcome
chemical_list: D004338:Drug Combinations; D006493:Heparin; D008012:Lidocaine