Treatment of bladder pain syndrome and interstitial cystitis: a systematic review.
OBJECTIVE
Bladder pain syndrome/interstitial cystitis (BPS/IC) has various treatments; however, no standardized treatment has been established. The aim was to analyze different types of treatment of BPS/IC and their effectiveness.


METHODS
A literature review with a search strategy for articles related to BPS/IC published between 1990 and 2014 was conducted on MEDLINE, PUBMED, and SCOPUS. Only randomized controlled trials in women were included in the meta-analysis, while other experimental studies were used as bases for a systematic review of the topic. Clinical trial quality was defined according to the Jadad scale.


RESULTS
Of 356 articles, 13 were included in the analysis. The intervention methods were as follows: instillation of hyaluronic acid, botulinum toxin A, intravesical lidocaine, hyperbaric chamber, massage, physiotherapy, phosphate-buffered saline, piroxicam in combination with doxepin, and others. We did not find any treatment with at least two randomized controlled trials for meta-analysis. Among the assessment tools for symptoms of BPS/IC, the most frequently used were the visual analogue scale, voiding record, and the O'Leary-Sant questionnaire.


CONCLUSIONS
Existing studies were not able to define the best approach for the treatment of BPS/IC. The lack of standardized treatment may be related to the diversity of interventions used; therefore, further studies with better methodological quality are needed.
Department of Gynecology and Obstetrics, Faculty of Medicine, University of São Paulo, Av. Bandeirantes, 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil.
Carolina
C
Pazin
Department of Gynecology and Obstetrics, Faculty of Medicine, University of São Paulo, Av. Bandeirantes, 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil.
Andréia Moreira
AM
de Souza Mitidieri
Department of Gynecology and Obstetrics, Faculty of Medicine, University of São Paulo, Av. Bandeirantes, 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil.
Ana Paula Moreira
AP
Silva
Department of Gynecology and Obstetrics, Faculty of Medicine, University of São Paulo, Av. Bandeirantes, 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil.
Maria Beatriz Ferreira
MB
Gurian
Department of Gynecology and Obstetrics, Faculty of Medicine, University of São Paulo, Av. Bandeirantes, 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil.
Omero Benedicto
OB
Poli-Neto
Department of Gynecology and Obstetrics, Faculty of Medicine, University of São Paulo, Av. Bandeirantes, 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil. juliocrs@usp.br.
Julio Cesar
http://orcid.org/0000-0001-6930-1328
JC
Rosa-E-Silva
D065087:Acetylcholine Release Inhibitors / Q000008:administration & dosage; D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D000283:Administration, Intravesical; D000779:Anesthetics, Local / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage; D018856:Cystitis, Interstitial / Q000628:therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D006931:Hyperbaric Oxygenation; D008012:Lidocaine / Q000008:administration & dosage; D010426:Pentosan Sulfuric Polyester / Q000008:administration & dosage; D026741:Physical Therapy Modalities; D012965:Sodium Chloride / Q000008:administration & dosage
D065087:Acetylcholine Release Inhibitors; D000276:Adjuvants, Immunologic; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000928:Antidepressive Agents; D010426:Pentosan Sulfuric Polyester; D012965:Sodium Chloride; D006820:Hyaluronic Acid; D008012:Lidocaine; D019274:Botulinum Toxins, Type A
Bladder pain syndrome; Drug treatment; Interstitial cystitis; Prospective and clinical trials