Interstitial cystitis/bladder pain syndrome (IC/BPS): Single‐center 20 year experience and treatment results in India

Abstract

Interstitial cystitis/bladder pain syndrome (IC/BPS) is an enigmatic disease that is difficult to treat. Even among physicians, the prevalent belief is that patients do not improve over time. In this study, we retrospectively reviewed our experience and treatment results for patients diagnosed with IC/BPS at our clinic in India over the past 20 years. Materials and Methods: Three hundred and eighty IC/BPS patients diagnosed between January 2001 and December 2020 were included. Patients underwent cystoscopy and hydrodistension and were treated with oral drugs, intravesical instillations, and surgery as needed. From January 2021 to June 2021, all patients were contacted by telephone. Results:The study had 380 participants, but only 231 could be contacted for analysis. Follow-up averaged 6.37 years and the median was 14 years. Eighteen percent showed no improvement, 2% showed a slight improvement on Global Response Assessment (GRA) questionnaire and were considered nonresponders (NR). Yet, 67% reported notable improvements, and 13% moderate improvements, all of which make up 80% responders (R). In 11 patients who were operated on for ileocystoplasty, 9 showed significant improvements. In addition, three patients developed Urothelial Malignancy. Pregnancy did not affect the disease in any way.Conclusions: Long-term results have been encouraging for IC/BPS patients.Unfortunately, Hunner's lesions patients need a more intensive treatment regimen. Re-evaluation with cystoscopy is recommended in NR. In spite of good results of surgery in our series, it is best to perform surgery only as a last resort.bladder pain syndrome, interstitial cystitis, intravesical instillation, treatment outcome | INTRODUCTIONInterstitial cystitis/bladder pain syndrome (IC/BPS) is a neglected, debilitating, chronic, and inflammatory disorder of the urinary bladder characterized by variable degrees of bladder pain, frequency, and urinary urgency. 1 The disease is not adequately understood by many physicians and is difficult to diagnose and difficult to treat. Over the past 30 years, the global efforts of many dedicated urologists, backed by patient organizations from many countries, have led to a tremendous increase in awareness among physicians and patients. Most physicians now accept

Understanding a standard approach to the treatment of interstitial cystitis

“…VAS scores are also likely to differ for different treatment modalities, as inferred from a systematic review study which reported that VAS score improved in cyclosporine A group compared to pentosan polysulfate sodium group. 10,11 In our study, 11% and 42% patients who received oral therapy and tacrolimus, respectively, had "very severe pain" in VAS assessment at baseline, which reduced to 3% and 8%, respectively, at 3month follow-up.…”

“…One of the studies has reported that in their evaluation ICSI was considerably decreased in the amitriptyline (MD: -4.9), cyclosporine A (MD: -7.9), and certolizumab pegol (MD: -3.6) groups compared to the placebo group. 10,11 Analysis of IUSS scores at baseline found that about two-third (61.8%; N=34) patients with IC/BPS experienced severe disease condition. At 3-month follow-up, about three quarters (76%; N=42) patients with IC/BPS experienced mild disease condition.…”

Interstitial cystitis—an imbalance of risk and protective factors?

“…IC in humans and cats also appears to be a dimensional rather than a categorical condition; patients may have minimal, mild, moderate, or severe symptoms that can vary over time rather than simply being present or absent. This has been studied most commonly in women (63)(64)(65). IC is also dimensional in cats, and more commonly severe in males because they can develop urethral obstruction (66).…”