Patient Perceived Outcomes of Treatments Used for Interstitial Cystitis

Hill, James L.; Isom-Batz, Ginger; Panagopoulos, Georgia; Zakariasen, Kay; Kavaler, Elizabeth

doi:10.1016/j.urology.2007.09.011

Cited by 29 publications

(14 citation statements)

References 14 publications

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“…Finally, we utilize Urised as an antispasmodic. Little information is available on antispasmodic use for treating PBS/IC, although Hill recently reported that patients taking phenothiazide consistently reported PBS/IC symptom reduction while on this medication (18). This observation matches our own clinical experience.…”

Section: Commentssupporting

confidence: 80%

Multimodal therapy for painful bladder syndrome / interstitial cystitis: pilot study combining behavioral, pharmacologic, and endoscopic therapies

et al. 2009

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Purpose:We evaluated the effectiveness of combining behavioral therapy, pharmacologic therapy and endoscopic hydrodistension for treating painful bladder syndrome / interstitial cystitis (PBS/IC). Materials and Methods: Twenty-five patients with PBS/IC were prospectively enrolled in a pilot multimodal behavioral, pharmacologic and endoscopic treatment protocol. Behavioral modification included diet recommendations, fluid restriction to 64 oz. /day, progressive timed voiding and Kegel exercises. Oral pharmacologic therapy consisted of daily doses of macrodantin 100 mg, hydroxyzine 10-20 mg and urised 4 tablets. Patients underwent endoscopic bladder hydrodistention under anesthesia at least 2 weeks after protocol enrollment. Behavioral and pharmacological treatments were continued after the hydrodistention. O'Leary-Sant questionnaire scores were recorded before starting the protocol, after pharmacologic/behavioral therapy, 2 months post-hydrodistension, and at scheduled follow-up. Results: Eighteen patients (72%) completed the pilot multimodal treatment protocol and were followed for a mean of 10.2 months. All patients were female with a median age of 36.3 years and had mean bladder capacity under anesthesia of 836 milliliters. Mean O'Leary-Sant symptom index scores for baseline symptoms, after behavioral/pharmacologic treatment, post-hydrodistension and during follow up were 12.5, 8.6, 7.0, and 6.7 (p < 0.05). Mean O'Leary-Sant problem index scores for baseline, after behavioral/pharmacologic treatment, post-hydrodistention and during follow up were 12.7, 8.9, 6.7, and 7.7 (p < 0.05). Conclusion: Our pilot multimodal protocol of behavioral modification, pharmacologic therapy and endoscopic hydrodistention demonstrated a significant progressive improvement in PBS/IC quality of life scores, compared to a pre-treatment baseline. These results should be validated in a larger, placebo controlled trial.

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Section: Commentssupporting

confidence: 80%

Multimodal therapy for painful bladder syndrome / interstitial cystitis: pilot study combining behavioral, pharmacologic, and endoscopic therapies

et al. 2009

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“…An initial analysis has been published and describes the diagnostic and therapeutic experience of the first 750 patients completing the survey. 6 The questionnaire was promoted by IC/BPS support groups and queried the impact of therapies (beneficial and deleterious effects) using a total of 202 unvalidated questions. Standard and common IC/BPS therapies such as oral medications, intravesical therapies and surgery were addressed and patients were asked whether symptoms were improved, deteriorated or were unchanged.…”

Section: Methodsmentioning

confidence: 99%

Treatment effectiveness in interstitial cystitis/bladder pain syndrome: Do patient perceptions align with efficacy-based guidelines?

Lusty

Kavaler

Zakariasen³

et al. 2017

CUAJ

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Introduction: We sought to determine if patients’ perceptions of success or failure of interstitial cystitis/bladder pain syndrome (IC/ BPS) therapies proposed in treatment guidelines align with the evidence from available clinical trial treatment data.Methods: A total of 1628 adult females with a self-reported diagnosis of IC completed a web-based survey in which patients described their perceived outcomes with the therapies they were exposed to. Previously published literature, used in part to develop IC/ BPS guidelines, provided the clinical trial data outcomes. Patientreported outcomes were compared to available clinical trial outcomes and published treatment guidelines.Results: Based on patient perceived outcomes (benefit:risk ratio), the most effective treatments were opioids, phenazopyridine, and alkalizing agents, with amitriptyline and antihistamines reported as moderately effective. The only surgical procedure with any effectiveness was electrocautery of Hunner’s lesions. In order of efficacy reported in the literature, the therapies for IC/BPS with predicted superior outcomes should be: cyclosporine A, amitriptyline, hyperbaric oxygen, pentosan polysulfate plus subcutaneous heparin, botulinum toxin A plus hydrodistension, and L-arginine. While some of the guideline recommendations aligned with patientreported effectiveness data, there was a general disconnect between guidelines and effectiveness reported in clinical practice.Conclusions: There is a disconnect between real-world patient perceived effectiveness of IC/BPS treatments compared to the efficacy reported from clinical trial data and subsequent guidelines developed from this efficacy data. Optimal therapy must include the best evidence from clinical research, but should also include real-life clinical practice implementation and effectiveness.

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“…[1][2][3] In addition, this drug is being used as a therapeutic option in patients with chronic bladder pain syndrome/interstitial cystitis (BPS/IC) beside hydrodistention, amitriptyline, or pentosan polysulfate sodium. 4,5 But there is little information available on the mode of action of the drug including sensory mechanisms, which have been referred afferent functions in the rat.…”

Section: Introductionmentioning

confidence: 99%

Effects of phenazopyridine on rat bladder primary afferent activity, and comparison with lidocaine and acetaminophen

Aizawa

Wyndaele

2010

Neurourology and Urodynamics

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Patient Perceived Outcomes of Treatments Used for Interstitial Cystitis

Cited by 29 publications

References 14 publications

Multimodal therapy for painful bladder syndrome / interstitial cystitis: pilot study combining behavioral, pharmacologic, and endoscopic therapies

Multimodal therapy for painful bladder syndrome / interstitial cystitis: pilot study combining behavioral, pharmacologic, and endoscopic therapies

Treatment effectiveness in interstitial cystitis/bladder pain syndrome: Do patient perceptions align with efficacy-based guidelines?

Effects of phenazopyridine on rat bladder primary afferent activity, and comparison with lidocaine and acetaminophen

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