title: Predictors of response to intravesical dimethyl-sulfoxide cocktail in patients with interstitial cystitis.
abstract: OBJECTIVE
  To identify predictors of treatment failure of dimethyl sulfoxide (DMSO) "cocktail" for patients with interstitial cystitis (IC).
  
  
  METHODS
  Fifty-one IC patients received weekly intravesical instillations of "cocktail" composed of 50% DMSO (50 mL), 100 mg of hydrocortisone (5 mL), 10,000 U of heparin sulfate (10 mL), and 0.5% bupivacaine (10 mL) for 12 weeks. A reduction from baseline in the O'Leary-Sant questionnaire score of ≥ 30% was considered as a response. Patients were evaluated every 3 weeks during the treatment course and at 1, 3, 6, 9, and 12 months thereafter. In addition, patients filled in a 3-day bladder diary and a 0-10 visual analogue scale (VAS) for pain. Responders and nonresponders were compared and predictors of treatment failure were identified using univariate analysis and multiple logistic regression.
  
  
  RESULTS
  Thirty-one patients (61%) were responders. A significant decrease from baseline in the mean questionnaire's score (27.2 ± 2.8 vs 18.8 ± 2.0, P = .0001) was noted in the responders group. Improvements in the mean daily number of micturitions (16.7 ± 3.6 vs 14.8 ± 2.8, P = .003) and in the mean VAS (7.6 ± 1.6 vs 3.6 ± 1.0, P = .0001) were noted as well. In the nonresponders group, none of these variables improved significantly. Patient age, menopausal state, body mass index, diabetes mellitus, and cystometric and anesthetic capacities were all associated with response. However, only an anesthetic bladder capacity <675 mL independently predicted treatment failure (odds ratio 83, 95% CI 9-714, P < .0001).
  
  
  CONCLUSIONS
  Intravesical cocktail for IC patients is associated with a 61% response rate. A small anesthetic bladder capacity predicts treatment failure.
authors: Department of Urology, Assaf Harofeh Medical Center, Zerifin, Israel. stavkobi@gmail.com
authors: Kobi
authors: K
authors: Stav
authors: Ilia
authors: I
authors: Beberashvili
authors: Arie
authors: A
authors: Lindner
authors: Dan
authors: D
authors: Leibovici
mesh_terms: D000283:Administration, Intravesical; D000328:Adult; D018856:Cystitis, Interstitial / Q000188:drug therapy*; D004121:Dimethyl Sulfoxide / Q000008:administration & dosage*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017211:Treatment Failure
chemical_list: D004338:Drug Combinations; D004121:Dimethyl Sulfoxide