Intravesical Bacillus Calmette-Guerin and Dimethyl Sulfoxide for Treatment of Classic and Nonulcer Interstitial Cystitis:: A Prospective, Randomized Double-Blind Study

Peeker, Ralph; Haghsheno, Mohammad-Ali; Holmäng, Sten; Fall, Magnus

doi:10.1016/s0022-5347(05)66916-9

Cited by 107 publications

(51 citation statements)

References 31 publications

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“…110 Two RCTs compared DMSO to Bacillus Calmette-Guerin (BCG), one favouring DMSO (30% response rate compared to 10% for BCG, p<0.05) 111 and one concluding no benefit with either regimen. 112 Finally, two other RCTs compared DMSO to chondroitin sulfate (CS), or to CS plus hyaluronic acid, with significantly better performances of CS groups over DMSO for both objective and subjective outcomes (14-53 % for DMSO against 73% for GAG, p<0.05). 113,114 Other observational studies have described use of DMSO in combination with corticoids, bicarbonate, or heparin.…”

Section: Dimethylsulfoxide (Dmso) (Recommended In Select Patients Grmentioning

confidence: 99%

CUA guideline: Diagnosis and treatment of interstitial cystitis/ bladder pain syndrome

Cox

Golda

Nadeau

et al. 2016

CUAJ

115

121

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MethodologyThe following guidelines were based on MEDLINE and PUBMED searches of English language literature, in addition to consensus conference proceedings. Levels of evidence and grades of recommendation were assigned for each investigation and treatment, as per the modified Oxford Centre for Evidence-Based Medicine grading system. Where the literature was inconsistent or scarce, a consensus expert opinion was generated to provide treatment guidelines.

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Section: Dimethylsulfoxide (Dmso) (Recommended In Select Patients Grmentioning

confidence: 99%

CUA guideline: Diagnosis and treatment of interstitial cystitis/ bladder pain syndrome

Cox

Golda

Nadeau

et al. 2016

CUAJ

115

121

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“…In one trial, BoNTA showed a significant treatment effect on pain, urinary frequency, and urgency compared with BCG, but these findings require further research for confirmation [45]. The mechanism of BCG in IC/PBS treatment remains unclear though it may be related to local immune system impairment [28]. As shown above, BCG significantly improved GRA and urinary urgency in IC/PBS patients.…”

Section: Discussionmentioning

confidence: 92%

“…1). After a full-text review, the reasons for excluding reports were non-RCTs [4,26], other intervention interference [27,28], other similar diseases [9,29,30], and lack of desired outcome assessment [31]. The general characteristics of the studies included are presented in Table 1.…”

Section: Resultsmentioning

confidence: 99%

Intravesical treatment for interstitial cystitis/painful bladder syndrome: a network meta-analysis

et al. 2016

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Introduction and hypothesis Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic inflammatory condition of the submucosal and muscular layers of the bladder. So far, there is no effective and targeted treatment strategy for IC/ PBS. This study aimed to assess the efficacy and safety of intravesical instillation treatment in IC/PBS patients. Methods We searched various databases up to October 2015. A network meta-analysis was performed to compare global response assessment (GRA) for different treatment strategies, including botulinum toxin A (BoNTA), bacillus CalmetteGuerin (BCG), resiniferatoxin (RTX), lidocaine, chondroitin sulfate (CS), oxybutynin, and pentosan polysulfate (PPS). A traditional meta-analysis was also performed. Results Sixteen trials evaluating 905 patients were included. Network meta-analysis indicated that BoNTA had the highest probability of being the best treatment course according to GRA assessment results (probability 81.7 %). BCG or BoNTA therapy yielded significant improvement in GRA incidence according to traditional meta-analysis. Patients who received PPS showed higher urinary frequency results compared with the placebo groups. BCG-and PPS-treated patients had elevated urinary urgency treatment effects compared with placebo groups. Bladder capacity restoration results also showed significant improvements in patients who received BoNTA compared with placebo-treated individuals. Conclusions These findings indicate that BoNTA therapy has the highest probability of being the best therapy according to GRA, and significantly improves bladder capacity in IC/PBS patients. BCG treatment also significantly increases the incidence of GRA and improves the symptoms of urinary urgency. PPS can significantly improve urinary frequency and urgency symptoms in IC/PBS patients.

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“…In addition, in two other RCTs, the group receiving intravesical BCG had no or marginal improvement (82,84). Oxybutynin, which has an anti-cholinergic effect reducing bladder spasm, was shown to significantly increase bladder capacity and was correlated with reduced frequency and improved quality of life (85).…”

Section: Intravesical Therapiesmentioning

confidence: 99%

“…The mechanism of action includes inhibition of mast cell activation with analgesic and inflammatory effects. Two rather small RCTs support its beneficial effect (81,82). However, the side effects of DMSO (garlic-like smell, taste) makes it almost impossible to perform a real placebocontrolled RCT.…”

Section: Intravesical Therapiesmentioning

confidence: 99%

Interstitial Cystitis

Moutzouris

Falagas

2009

Clinical Journal of the American Society of Nephrology

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Painful bladder syndrome/interstitial cystitis (PBS/IC) is a chronic disease of unknown etiology characterized by vague bladder pain and nonspecific urinary symptoms, such as urgency and frequency. Although it was initially considered to be a rare condition, its prevalence has significantly increased, possibly because of different definitions used and greater physician awareness. Because of the multiple diagnostic criteria used, there is significant variation in its prevalence. In addition, there is often a delay in the diagnosis of PBS/IC. It affects predominantly women of middle age, and it significantly decreases quality of life. Diagnosis of PBS/IC is mainly a diagnosis of exclusion; there are no characteristic symptoms or pathognomonic findings. Therefore, it is important to rule out diseases that have a similar clinical picture (i.e., urinary infections, bladder carcinoma) but definite therapies and worse prognosis if left untreated. PBS/IC management suffers from lack of evidence; many therapies are empiric or based on small studies and case series. Treatment includes supportive therapies (psychosocial, behavioral, physical), oral treatments, and intravesical treatments, whereas other more invasive treatments such as electric neuromodulation and reconstructive surgery are reserved for refractory cases. Physicians should always keep in mind the diagnosis of PBS/IC in patients presenting with chronic urinary symptoms after excluding other more common diseases.

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Intravesical Bacillus Calmette-Guerin and Dimethyl Sulfoxide for Treatment of Classic and Nonulcer Interstitial Cystitis:: A Prospective, Randomized Double-Blind Study

Cited by 107 publications

References 31 publications

CUA guideline: Diagnosis and treatment of interstitial cystitis/ bladder pain syndrome

CUA guideline: Diagnosis and treatment of interstitial cystitis/ bladder pain syndrome

Intravesical treatment for interstitial cystitis/painful bladder syndrome: a network meta-analysis

Interstitial Cystitis

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