Current standard of care in treatment of bladder pain syndrome/interstitial cystitis

Lopez S. R., MANGIR N.

THERAPEUTIC ADVANCES IN UROLOGY, cilt.13, 2021 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 13
  • Basım Tarihi: 2021
  • Doi Numarası: 10.1177/17562872211022478
  • Dergi Adı: THERAPEUTIC ADVANCES IN UROLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Directory of Open Access Journals
  • Anahtar Kelimeler: bladder pain syndrome, interstitial cystitis, pathophysiology, treatment, URINARY-TRACT FUNCTION, INTRAVESICAL RESINIFERATOXIN, DETRUSOR OVERACTIVITY, DOUBLE-BLIND, HYPERSENSITIVE BLADDER, INTERSTITIAL CYSTITIS, CONTROLLED-TRIAL, RECEPTOR, CAPSAICIN, CANNABIS
  • Hacettepe Üniversitesi Adresli: Evet

Özet

Bladder pain syndrome/interstitial cystitis (BPS/IC) is a debilitating, systemic pain syndrome with a cardinal symptom of bladder related pain with associated systemic symptoms. It is characterized by an inflammation that partially or completely destroys the mucus membrane and can extend into the muscle layer; however, the etiology and pathogenesis is still enigmatic. It has been suggested that mast cell activation, defects in the glycosaminoglycan layer, non-functional proliferation of bladder epithelial cells, neurogenic inflammation, microvascular abnormalities in the submucosal layer, autoimmunity and infectious causes may cause BPS/IC. Available treatment options include general relaxation techniques, patient education, behavioral treatments, physical therapy, multimodal pain therapy, oral (amitriptyline, cimetidine, hydroxyzine) and intravesical treatments (heparin, lidocaine, hyaluronic acid and chondroitin sulfate), hydrodistension and other more invasive treatments. Available treatments are mostly not based on a high level of evidence. Lack of understanding of disease mechanisms has resulted in lack of targeted therapies on this area and a wealth of empirical approaches with usually inadequate efficacy. The aim of this article is to review the available evidence on the pathophysiological mechanisms of BPS/IC as they relate to available treatment options.