Cochrane Review: Intravesical Treatments for Bladder Pain Syndrome/ Interstitial Cystitis

Hypothesis / aims of study Painful bladder syndrome (PBS) is defined by the International Continence Society (ICS) as “the complaint of suprapubic pain in relation to bladder filling, accompanied by other symptoms such as increased daytime and night-time frequency, in the absence of proven urinary tract infection or other obvious pathology”. ICS reserves its diagnosis of interstitial cystitis (IC) to patients with “typical cystoscopic and histological features”. Bladder pain syndrome (BPS) is defined by the European Society for the Study of Interstitial Cystitis/Bladder Pain as “pelvic pain, pressure or discomfort perceived to be related to the bladder, lasting for at least 6 months, and accompanied by at least one other urinary symptom”. This is a chronic condition affecting mostly women. Treatments are varied and include dietary/lifestyle modifications, oral medication, intravesical instillations or injections and, in some cases, surgery. Rates of treatment success are generally modest and there is little consensus as to the best form of treatment for this condition. This meta-analysis of Randomised Controlled Trials (RCTs) summarises the evidence of the effects of intravesical treatment in the management of bladder pain syndrome. This is an update of the 2007 Cochrane review (1).