title: Effect of amitriptyline in treatment interstitial cystitis or bladder pain syndrome according to two criteria: does ESSIC criteria change the response rate?
abstract: OBJECTIVE
  The European Society for the Study of Interstitial Cystitis (ESSIC) recommended that interstitial cystitis (IC) should be replaced by bladder pain syndrome (BPS), which focused more attention on the painful or discomfort feeling related to bladder and weakened the importance of cystoscopy in diagnosis process. Our study aimed to explore whether this alteration changed the treatment outcomes of amitriptyline and whether cystoscopy was meaningful for the treatment of this disease.
  
  
  METHODS
  We conducted a retrospective study including 25 IC patients fulfilled the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) criteria and 42 BPS patients diagnosed according to ESSIC criteria. All the patients received amitriptyline with a self-uptitration protocol. We compared the response rates of two groups by a patient reported global response assessment after 3 months and reclassified all the 67 patients according to ESSIC criteria, the response rates of different BPS types were also assessed.
  
  
  RESULTS
  There was no significant difference of response rate between IC patients (12/25, 48%) and BPS patients (19/42, 45.2%) according to different criteria (P = 0.337). The response rate of BPS type 1 (13/30, 43.3%) was similar to that of type 2 or 3 (18/37, 48.6%) (P = 0.664).
  
  
  CONCLUSIONS
  ESSIC criteria did not decrease the response rate of amitriptyline treatment for BPS patients compared to IC patients with complaint of bladder pain or discomfort. Cystoscopy showed no predictive effect for the treatment outcome of amitriptyline.
authors.affiliation: Department of Urology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Yaofei
authors.initials: Y
authors.lastname: Sun
authors.forename: Zujun
authors.initials: Z
authors.lastname: Fang
authors.forename: Qiang
authors.initials: Q
authors.lastname: Ding
authors.forename: Jie
authors.initials: J
authors.lastname: Zheng
mesh_terms: D000639:Amitriptyline / Q000627:therapeutic use*; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D018856:Cystitis, Interstitial / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D003558:Cystoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017699:Pelvic Pain / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D009626:Terminology as Topic; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000187:drug effects* / Q000503:physiopathology
chemical_list: D018712:Analgesics, Non-Narcotic; D000639:Amitriptyline
keywords: amitriptyline; bladder pain syndrome; interstitial cystitis