Safety and dose flexibility clinical evaluation of intravesical liposome in patients with interstitial cystitis or painful bladder syndrome. Multimodal therapy for painful bladder syndrome / interstitial cystitis: pilot study combining behavioral, pharmacologic, and endoscopic therapies. Intravesical hyaluronic acid and alkalinized lidocaine for the treatment of severe painful bladder syndrome/interstitial cystitis A combined intravesical therapy with hyaluronic acid and chondroitin for refractory painful bladder syndrome/interstitial cystitis A multicenter, randomized, double-blind, parallel group pilot evaluation of the efficacy and safety of intravesical sodium chondroitin sulfate versus vehicle control in patients with interstitial cystitis/painful bladder syndrome. A placebo-controlled study of intravesical pentosanpolysulphate for the treatment of interstitial cystitis. Treatment of interstitial cystitis with Cystistat®, A hyaluronic acid product Results of endovesical hyaluronic acid/chondroitin sulfate in the treatment of Interstitial Cystitis/Painful Bladder Syndrome. Intravesical hyaluronic acid for interstitial cystitis/painful bladder syndrome: a comparative randomized assessment of different regimens. Combined intravesical sodium hyaluronate/chondroitin sulfate therapy for interstitial cystitis/bladder pain syndrome: a prospective study Association between response to pentosan polysulfate sodium therapy for interstitial cystitis and patient questionnaire-based treatment satisfaction* A prospective, double‐blind, randomized cross‐over study evaluating changes in urinary pH for relieving the symptoms of interstitial cystitis Randomized multicenter clinical trial of myofascial physical therapy in women with interstitial cystitis/painful bladder syndrome and pelvic floor tenderness. Successful downregulation of bladder sensory nerves with combination of heparin and alkalinized lidocaine in patients with interstitial cystitis. Intravesical liposome versus oral pentosan polysulfate for interstitial cystitis/painful bladder syndrome. Improvement of interstitial cystitis symptoms and problems that developed during treatment with oral IPD-1151T. Effect of intravesical glycosaminoglycan substitution therapy on bladder pain syndrome/interstitial cystitis, bladder capacity and potassium sensitivity
To present single institution open-label experience with intravesical liposomes ( LPs ) , a mucosal protective agent , in patients with interstitial cystitis/painful bladder syndrome ( IC/PBS ) and to assess the safety and efficacy on IC/PBS symptoms . A total of 17 symptomatic IC/PBS patients were treated with intravesical LPs ( 80mg/40mL distilled water ) once a week for 4 weeks ( n=12 ) or twice a week treatment for 4 weeks ( n=5 ) . The primary outcome was the change in the O'Leary-Sant Symptom/Problem score and O'Leary-Sant total Score from baseline to Week 4 and Week 8 . Other outcome measurements included the changes in pain scale , urgency scale , voiding log , and patient global assessment . Both weekly and biweekly LP instillation regiments were well tolerated . The incidence of urinary incontinence , retention , or unanticipated adverse changes was not noted at any dose either during the treatment or at the 4-week follow-up . The O'Leary-Sant Symptom/Problem score , O'Leary-Sant total Score , and pain score were significantly improved from baseline at both dose regimens with added benefit with the biweekly regimen . Intravesical LPs treatment is safe and its efficacy has sustained duration . Furthermore large-scale , placebo-controlled studies are warranted to assess the efficacy for this promising new treatment for IC/PBS PURPOSE We evaluated the effectiveness of combining behavioral therapy , pharmacologic therapy and endoscopic hydrodistension for treating  painful bladder syndrome / interstitial cystitis ( PBS/IC ) .  MATERIAL S AND METHODS Twenty-five patients with PBS/IC were prospect ively 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 question naire 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 vali date d in a larger , placebo controlled trial Introduction and hypothesisIntravesical instillation of hyaluronic acid ( HA ) may restore the integrity of glycosaminoglycan layer in patients with painful bladder syndrome/interstitial cystitis ( PBS/IC ) , and the benefit may be improved with addition of alkalinized lidocaine ( AL ) . Methods 48 women with severe PBS/IC who failed oral medications were enrolled and divided into one trial and two control groups . The trial group received intravesical 40 mg HA , 10 ml of 2 % lidocaine and 5 ml of 8.4 % sodium bicarbonate on a weekly basis for 8 weeks and then monthly for 4 months with a subsequent follow-up of 24 weeks , while the two control groups received 40 mg HA and mixture of 10 ml of 2 % lidocaine and 5 ml of 8.4%sodium bicarbonate respectively following the same procedure . Response to therapy was evaluated by Global Response Assessment , voids per day , Visual Analogue Scale for pain , frequency and urgency , O’leary-Sant Interstitial Cystitis Symptom Index and Problem Index , cystoscopy and bladder capacity . Results Overall 45 patients finished this study protocol . The HA + AL group and the AL group showed significant improvement at week 2 ( P < 0.01 ) , while the HA group began to show effect at week 4 ( P < 0.01 ) . There was no improvement in the AL group at week 24 and these patients quitted the study without follow up . Contrarily , the HA + AL and HA group kept on improving till the end of the study without significant difference between the two groups . Conclusions Intravesical instillation of HA and AL may provide both immediate and sustained relief of symptoms in severe PBS/IC in this preliminary study The aims of this study were to evaluate the efficacy and tolerability of intravesical instillations of high-molecular-weight hyaluronic acid ( HA ) 1.6 % and chondroitin sulfate ( CS ) 2.0 % in patients with refractory painful bladder syndrome/interstitial cystitis ( PBS/IC ) and to observe their impact on Quality of Life . Twenty-three women were enrolled . They received bladder instillations with HA and CS weekly for 20 weeks and then monthly for 3 months . Mean follow-up after completion of therapy was 5 months . We observed a significant improvement in urinary symptoms on voiding diaries and Visual Analogue Scale for frequency ( p = 0.045 ) , urgency ( p = 0.005 ) , and pain ( p = 0.001 ) . The O’Leary – Sant Interstitial Cystitis Symptom Index and Interstitial Cystitis Problem Index result ed in a significant improvement in both scores ( p = 0.004 and 0.01 , respectively ) . The Pelvic Pain and Urgency/Frequency Symptom Scale only showed significant improvement in the symptom score ( p = 0.001 ) . This promising experience seems to offer an additional therapeutic option in patients with refractory PBS/IC OBJECTIVE The goal of this pilot study was to gather information on differences between intravesical chondroitin sulfate and inactive vehicle control for treatment of interstitial cystitis/painful bladder syndrome ( IC/PBS ) . METHODS This was a prospect i ve , r and omized , double-blind , inactive vehicle-controlled , 12-week study ( 6-week treatment period , followed by a 6-week follow-up period ) in patients with IC/PBS . Patients were r and omized to weekly intravesical treatment with 2.0 % sodium chondroitin sulfate in phosphate-buffered saline or intravesical vehicle control . Primary efficacy analysis compared responders ( moderately or markedly improved ) according to the 7-point Global Response Assessment . Secondary endpoints include question naires focused on symptoms and quality of life . RESULTS Sixty-five evaluable patients were r and omized . At the primary endpoint analysis ( week 7 ) , 22.6 % of the vehicle control group were responders compared with 39.4 % of the active therapy group ( P = .15 ) . There was no statistically significant difference for any of the secondary endpoints . Overall , 76.9 % of the patients in the study reported at least 1 adverse event ; most were mild or moderate , the majority associated with the vehicle control treatment . Nine nonserious intervention-related adverse events were reported in 3 patients in the vehicle control group compared with 2 in 1 patient in the active treatment group . CONCLUSION The difference in treatment effect in this small underpowered study was not statistically significant , although twice as many patients reported a clinical ly significant benefit with intravesical chondroitin sulfate treatment compared with vehicle control treatment . This trial provides data required to design a well-powered r and omized vehicle-controlled trial to determine the true efficacy of this potentially promising therapy OBJECTIVE To evaluate the therapeutic efficacy of intravesical pentosanpolysulphate ( PPS ) compared with placebo in patients with interstitial cystitis ( IC ) . PATIENTS AND METHODS Twenty patients who fulfilled the diagnostic criteria for IC participated in a double-blind placebo-controlled study ; 10 received intravesical PPS ( 300 mg in 50 mL of 0.9 % sodium chloride ) applied twice a week for 3 months and the other 10 received a placebo .  Symptomatic relief and objective variables ( bladder capacity voiding volumes and urinary frequency ) were assessed after 3 months and the long-term outcome of those continuing treatment was determined . RESULTS Of the patients treated with PPS , four gained significant symptomatic relief compared with only two receiving placebo . Only the urodynamic bladder capacity showed a statistically significant increase in patients treated with PPS ( P = 0.047 ) . At 18 months from the start of the study , the symptoms were relieved in eight patients while still receiving PPS instillations and in four without treatment . CONCLUSIONS These results suggest that intravesical PPS is an effective option for the treatment of IC and shows that the intravesical application of PPS is a safe treatment with no important side-effects Objective . To determine whether intravesical hyaluronic acid is effective in reducing the urinary frequency and pain associated with interstitial cystitis/painful bladder syndrome ( IC/PBS ) . Material and methods . In a prospect i ve , unblinded , uncontrolled pilot study , 20 patients ( age range 34–80 years ) , all suffering from IC/PBS , received weekly bladder instillations of hyaluronic acid for 1 month and monthly instillations for a further 2 months . Patients were then offered further monthly instillations and all were subsequently evaluated after 3 years . Patient outcomes assessed were urinary frequency , use of analgesics and pain . Results . All patients completed the 3 months of hyaluronic acid treatment with mean decreases in nocturia and pain of 40 % and 30 % , respectively , and a decrease in analgesic use . Thirteen patients ( 65 % ) responded to treatment ( responders ) and continued therapy , while seven patients withdrew , six because of a lack of response and one due to cystectomy . In the 13 patients who continued hyaluronic acid instillations , four complete responders ( 30 % ) ceased therapy after a strong positive response ( 36 % , 60 % and 81 % decreases compared to baseline in day-time voids , night-time voids and pain scores , respectively ) which was maintained in the absence of continuous therapy , while after 3 years seven partial responders ( 35 % ) were still on therapy ( 25 % and 43 % decreases compared to baseline in day-time voids and pain scores , respectively ) . Two patients developed other diseases during follow-up and showed no response to long-term therapy . Hyaluronic acid was well tolerated by all patients . Conclusion . Hyaluronic acid safely reduced the pain and , to a lesser degree , the urinary frequency associated with IC OBJECTIVES The aim of our study was to test the effect of a more viscous compound than existent hyaluronic acid formulation in helping to restore a defective glycosaminoglycan layer , and therefore in improving Interstitial Cystitis/Painful Bladder Syndrome ( IC/PBS ) symptoms when administered intravesically in IC/PBS patients . METHODS A total of 23 female patients completed the study . Patients received endovesical administration of hyaluronic acid and chondroitin sulfate in normal saline , 40 ml , weekly for 12 weeks and then bi-weekly for 6 months , if there was initial response . RESULTS After 12 weeks treatment both Interstitial Cystitis Symptom and Problem Index ( ICSI/ICPI ) , pelvic pain and Urgency/Frequency Symptom Scale ( PUF ) showed a mean significant improvement , which was maintained thereafter . The average number of voidings and mean voiding volumes revealed significant improvement after the 12 weeks ' treatment period , with a significant reduction and increase , respectively . Mean voiding volume increased from 143 ml to 191 , which apparently was not reflected in a corresponding reduction of number of daily voids ( from 15,5 to 14 ) . VAS values decreased from 5,4 to 3,6 ( pain ) and from 6,0 to 3,5 ( urgency ) after the treatment cycle , showing a significant improvement . CONCLUSIONS In our preliminary experience , the administration of intravesical hyaluronic acid plus chondroitine sulphate appears to be a safe and efficacious method of treatment in IC/PBS OBJECTIVES To compare the clinical effectiveness of different regimens of intravesical hyaluronic acid instillation for patients with interstitial cystitis/painful bladder syndrome . METHODS A total of 60 patients ( age 16 - 77 years ) diagnosed with interstitial cystitis/painful bladder syndrome were enrolled in this prospect i ve , r and omized study . A total of 30 patients were assigned to receive four weekly intravesical instillations of 40 mg of hyaluronic acid followed by five monthly instillations ( hyaluronic acid-9 group ) . Another 30 patients received 12 intravesical instillations of 40 mg hyaluronic acid every 2 weeks ( hyaluronic acid-12 group ) . Symptomatic changes after hyaluronic acid treatments were assessed using Interstitial Cystitis Symptom and Problem Indexes , pain visual analog scale , functional bladder capacity , frequency and nocturia in voiding diary , maximum flow rate , voided volume , postvoid residual volume , and Quality of Life Index at 1 , 3 and 6 months . RESULTS Of the 60 patients , 59 were evaluable at the end of the study . The Interstitial Cystitis Symptom Index , Interstitial Cystitis Problem Index and total score , pain visual analog scale , functional bladder capacity , maximum flow rate , and Quality of Life Index improved significantly after 6 months in both groups . The frequency and voided volume improved significantly only in the hyaluronic acid-12 group . However , patients with moderate and marked improvement were clinical ly similar in both groups . The measured variables did not differ between the two groups over the course of the study . CONCLUSION No significant difference was noted in the therapeutic effect between two hyaluronic acid instillation regimens for treatment of interstitial cystitis/painful bladder syndrome patients . Both groups showed significant improvement in symptom scores and Quality of Life Index Objectives : The aim of this study was to verify the efficacy and safety of intravesical treatment combining sodium hyaluronate ( HA ) and chondroitin sulfate ( CS ) in patients with interstitial cystitis/bladder pain syndrome ( IC/BPS ) . Methods : Between February 2010 and May 2011 , 20 consecutive women with IC/BPS were treated with intravesical instillations containing sodium HA ( 1.6 % ; 800 mg/50 ml ) and sodium CS ( 2 % ; 1 g/50 ml ) weekly for the first month , biweekly for the second month , and then monthly for at least 3 months . Before and after treatment , all patients filled in the Interstitial Cystitis Symptom Index and Problem Index ( ICSI/ICPI ) , the Patient Health Question naire 9 and the Pelvic Pain and Urgency/Frequency Patient Symptom Scale ( PUF ) . Treatment efficacy was assessed by comparing the pre- and post-treatment mean scores of the three question naires using Student ’s t test ( p value < 0.05 was considered significant ) . Results : Statistically significant mean decreases in ICSI ( from 13.0 to 9.3 ; p = 0.0003 ) , ICPI ( from 11.35 to 8.85 ; p = 0.0078 ) and PUF ( from 20.0 to 15.75 ; p = 0.0007 ) question naire scores were seen . No cases of side effects or complications were observed . The mean follow up was 5 months . Conclusions : Despite the limitations of this study , the outcomes confirmed the role of combination therapy with HA and CS as a safe and effective option for the treatment of IC/BPS . Further r and omized controlled studies with a higher number of patients and a longer follow-up period are needed to confirm these results ABSTRACT Objective : To evaluate the relationship between symptom reduction and satisfaction with pentosan polysulfate sodium ( PPS ) therapy in subjects with interstitial cystitis ( IC ) . Methods : A secondary analysis was conducted in 128 subjects treated with PPS 300 mg/day ( US Food and Drug Administration-approved dose ) from a 32-week multicenter , r and omized , double-blind study of 380 subjects with IC who were treated with PPS 300 mg/day , 600 mg/day , or 900 mg/day .  Self-rated outcome measures included the O'Leary-Sant Interstitial Cystitis Symptom Index ( ICSI ) and a treatment satisfaction question naire . Treatment responders were defined as subjects having ≥30 % reduction in ICSI from baseline to study end point . Results : A reduction in IC symptoms was associated with significantly higher satisfaction with PPS ( p < 0.05 ) . Compared with nonresponders , subjects achieving a ≥30 % reduction in ICSI were more likely to be pleased with PPS for IC symptoms , to have benefited from PPS for their IC symptoms , to recommend PPS for IC symptoms to others with the same condition , and to say that PPS provides better relief , based on prior experience with other IC treatments . Among all subjects at week 32 , 75 % said they would recommend PPS therapy for IC symptoms to others with the condition . Conclusion : Despite limitations ( lack of placebo control , use of a nonvali date d instrument ) , this analysis demonstrated significantly increased treatment satisfaction with PPS therapy among treatment responders versus nonresponders . There was a significant positive correlation between ICSI scores and response on the treatment satisfaction question naire . Treatment response and patient satisfaction with treatment are important clinical considerations in the management of patients with IC To provide evidence for the clinical efficacy of changes in urinary pH on the pain associated with interstitial cystitis ( IC ) PURPOSE We determined the efficacy and safety of pelvic floor myofascial physical therapy compared to global therapeutic massage in women with newly symptomatic interstitial cystitis/painful bladder syndrome . MATERIAL S AND METHODS A r and omized controlled trial of 10 scheduled treatments of myofascial physical therapy vs global therapeutic massage was performed at 11 clinical centers in North America . We recruited women with interstitial cystitis/painful bladder syndrome with demonstrable pelvic floor tenderness on physical examination and a limitation of no more than 3 years ' symptom duration . The primary outcome was the proportion of responders defined as moderately improved or markedly improved in overall symptoms compared to baseline on a 7-point global response assessment scale . Secondary outcomes included ratings for pain , urgency and frequency , the O'Leary-Sant IC Symptom and Problem Index , and reports of adverse events . We compared response rates between treatment arms using the exact conditional version of the Mantel-Haenszel test to control for clustering by clinical center . For secondary efficacy outcomes cross-sectional descriptive statistics and changes from baseline were calculated . RESULTS A total of 81 women r and omized to the 2 treatment groups had similar symptoms at baseline . The global response assessment response rate was 26 % in the global therapeutic massage group and 59 % in the myofascial physical therapy group ( p=0.0012 ) . Pain , urgency and frequency ratings , and O'Leary-Sant IC Symptom and Problem Index decreased in both groups during followup , and were not significantly different between the groups . Pain was the most common adverse event , occurring at similar rates in both groups . No serious adverse events were reported . CONCLUSIONS A significantly higher proportion of women with interstitial cystitis/painful bladder syndrome responded to treatment with myofascial physical therapy than to global therapeutic massage . Myofascial physical therapy may be a beneficial therapy in women with this syndrome OBJECTIVES To test the efficacy of a new intravesical therapeutic solution in relieving urgency/frequency and pain in interstitial cystitis ( IC ) . METHODS A solution of 40,000 U heparin , 8 mL 1 % lidocaine ( 80 mg ; group 1 ) or 2 % lidocaine ( 160 mg ; group 2 ) , and 3 mL 8.4 % sodium bicarbonate was administered intravesically in patients with newly diagnosed IC with significant frequency , urgency , and pain . Using the Patient Overall Rating of Improvement of Symptoms , the response to treatment was evaluated within 20 minutes of instillation in all patients , after 24 to 48 hours in group 2 , and after three treatments per week for 2 weeks in group 2 patients who elected to receive additional instillations . Significant symptom relief was defined as 50 % or greater symptom improvement . RESULTS After one instillation , 35 ( 75 % ) of 47 patients in group 1 ( 1 % lidocaine ) and 33 ( 94 % ) of 35 in group 2 ( 2 % lidocaine ) reported significant immediate symptom relief . The difference in the response rates was statistically significant ( P < 0.01 ) . In group 2 , 50 % of the subjects experienced at least 4 hours of symptom relief from the single instillation , and 16 ( 80 % ) of 20 reported significant sustained symptom relief after 2 weeks of treatment . CONCLUSIONS Intravesical treatment with combined heparin and alkalinized lidocaine immediately reduced the pain and urgency of IC in most patients treated for newly diagnosed IC . Symptom relief lasted beyond the duration of the local anesthetic activity of lidocaine , suggesting the solution suppresses neurologic upregulation . In IC treatment , this new intravesical solution may be helpful in the interval before heparinoid therapy reaches its full effect PURPOSE We evaluated the safety and efficacy of intravesical liposomes , a mucosal protective agent , compared to oral pentosan polysulfate sodium for interstitial cystitis/painful bladder syndrome . MATERIAL S AND METHODS We performed a prospect i ve longitudinal study of the effect of 2 independent treatments ( intravesical liposomes and oral pentosan polysulfate sodium ) in patients with interstitial cystitis/painful bladder syndrome . Ten possible responses ( or measures ) to treatment were monitored at 3 time points , including baseline , and weeks 4 and 8 . A total of 24 patients with interstitial cystitis/painful bladder syndrome were evaluated in a 1:1 ratio to intravesical liposomes ( 80 mg/40 cc distilled water ) once weekly or to oral pentosan polysulfate sodium ( 100 mg ) 3 times daily for 4 weeks each . RESULTS No patient had urinary incontinence , retention or infection due to liposome instillation . There were no unanticipated adverse events and no significant worsening of symptoms during followup . Statistically significant decreases in urinary frequency and nocturia were observed in each treatment group . Statistically significant decreases in pain , urgency and the O'Leary-Sant symptom score were observed in the liposome group . Decreased urgency in the liposome group had the most profound effect of the ordinal measures . CONCLUSIONS Each glycosaminoglycan directed treatment seemed beneficial . Liposome intravesical instillation is safe for interstitial cystitis/painful bladder syndrome with potential improvement after 1 course of therapy for up to 8 weeks . Intravesical liposomes achieved efficacy similar to that of oral pentosan polysulfate sodium . Further large-scale placebo controlled studies are needed . Intravesical liposomes appear to be a promising new treatment for interstitial cystitis/painful bladder syndrome PURPOSE We examined the efficacy of Suplatast Tosilatedouble dagger ( IPD-1151 T ) , a new immunoregulator that suppresses helper T cell mediated allergic responses , including IgE production and eosinophilic inflammation for treating patients with interstitial cystitis . MATERIAL S AND METHODS A total of 14 women ( average age 43.7 years ) with interstitial cystitis , which was nonulcerative in 13 and ulcerative in 1 , were treated with 300 mg . IPD-1151 T orally daily for 12 months . All patients received laboratory assessment s , including hematology ( eosinophils and CD20 positive cells ) and serum chemistry ( IgE , and interleukin-4 ( IL-4 ) and 5 , and immunohistochemical analyses of urine leukocytes ( CD45RO positive cells as a T cell marker ) before treatment . These parameters were also measured 4 and 12 months after continuous treatment . The voiding chart , and interstitial cystitis symptom and problem indexes were evaluated before and after IPD-1151 T treatment . RESULTS IPD-1151 T treatment for 1 year result ed in a significantly increased bladder capacity and decreased symptoms , such as urinary urgency , frequency and lower abdominal pain , in patients with nonulcerative interstitial cystitis . These effects also correlated with a reduction in blood eosinophils , CD20 positive cells and IgE , and urine CD45RO positive memory T cells . No major side effects were observed . CONCLUSIONS Our study suggests that immunological responses are involved in the development of interstitial cystitis symptoms . IPD-1151 T could be a new oral agent for treatment of voiding symptoms and bladder pain in patients with interstitial cystitis Objective . To evaluate changes in bladder capacity and potassium sensitivity after glycosaminoglycan ( GAG ) substitution therapy . Material and methods . The study population comprised two groups of female patients with bladder pain syndrome/interstitial cystitis ( BPS/IC ) : responders ( those with symptom improvement ) and non-responders ( those without symptom improvement ) after a 10-week period of intravesical , episodic , weekly , GAG substitution therapy . A total of 27 volunteers with increased pre-therapeutic potassium sensitivity were enrolled in the study and re-evaluated using the modified comparative potassium test ( maximal bladder capacity with a saline solution versus a 0.2 M KCl solution ) following intravesical GAG substitution therapy . Results . In the 13 responders , the average maximal bladder capacity increased by 17 % with the saline solution and by 101.5 % with the 0.2 M KCl solution . In the 14 non-responders , post-therapeutic average maximal bladder capacity was decreased by 35 % with the saline solution and remained relatively unchanged after instillation with a 0.2 M KCl solution . Conclusion . These data demonstrate that in patients who respond symptomatically to intravesical GAG substitution therapy , cystometric bladder capacity is increased , whereas non-responders experience a decrease in bladder capacity
Current evidence also suggests the efficacy of  dimethyl sulfoxide and amitryptyline therapy .
Hydroxyzine , intravesical bacille Calmette-Guérin  , and  resiniferatoxin therapy  failed to demonstrate efficacy , but evidence was inconclusive owing to method ological limitations .
Pentosan polysulfate may be modestly beneficial for symptoms of PBS/IC .
There is insufficient evidence for other pharmacologic treatments .
BACKGROUND More than 180 different types of therapy have been used in the treatment and management of  painful bladder syndrome/interstitial cystitis ( PBS/IC ) , yet evidence from clinical trials remains inconclusive .
This study aim ed to evaluate the efficacy of pharmacologic approaches to PBS/IC , to quantify the effect size from r and omized controlled trials , and to begin to inform a clinical consensus of treatment efficacy for PBS/IC .