Journal article
Interstitial cystitis: bladder pain and beyond
Expert opinion on pharmacotherapy, v 9(17), pp 2979-2994
01 Dec 2008
PMID: 19006474
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Interstitial cystitis is characterized by over 6 months of chronic pain, pressure and discomfort felt in the lower pelvis or bladder. It is often relieved with voiding, along with daytime frequency and nocturia in the absence of a urinary tract infection. Interstitial cystitis occurs primarily in females including adolescents and its diagnosis is still one of exclusion. It is now recognized as a serious medical condition associated with significant disability.
The aim of this paper was to review the pathogenesis and treatment of interstitial cystitis with emphasis on new pathogenetic trends and therapeutic modalities.
About 713 mostly original papers were reviewed in Medline from 1990 to August. 2008. All authors independently reviewed the literature. Large, double-blind, placebo-controlled, clinical trials were few and the medical histories of the patients used varied considerably making conclusions difficult. Promising pilot trials turned out mostly negative on follow-up.
Increasing evidence of co-morbid diseases, neurogenic inflammation and the effect of stress are promising as new targets for pathophysiology. No new effective treatments have emerged. Oral pentosanpolysulfate, amitriptyline, hydroxyzine and quercetin, as well as intravesical heparin/bicarbonate/lidocaine solutions, are still used with variable success. Some pilot open-label trials presented encouraging findings.
Interstitial cystitis contributes substantially to chronic pelvic pain and to poor quality of life. Oral or intravesical administration of solutions containing sodium hyaluronate, chondroitin sulfate and quercetin to both reduce bladder inflammation and 'replenish' the glycosaminoglycan layer should be tried. There is a clear need for therapeutic modalities. New potential translational research areas are suggested.
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Details
- Title
- Interstitial cystitis: bladder pain and beyond
- Creators
- Theoharis C Theoharides - Tufts Medical CenterKristine Whitmore - Hahnemann University HospitalEdward StanfordRobert Moldwin - Arthur Smith Institute for UrologyMichael P O'LearyKristene E Whitmore
- Publication Details
- Expert opinion on pharmacotherapy, v 9(17), pp 2979-2994
- Grant note
- DK54133 / NIDDK NIH HHS AR47652 / NIAMS NIH HHS DK30102 / NIDDK NIH HHS DK44816 / NIDDK NIH HHS NS38326 / NINDS NIH HHS DK65244 / NIDDK NIH HHS UO1 DK065187 / NIDDK NIH HHS DK62861 / NIDDK NIH HHS DK42409 / NIDDK NIH HHS DK63652 / NIDDK NIH HHS
- Resource Type
- Journal article
- Language
- English
- Web of Science ID
- WOS:000261224600005
- Scopus ID
- 2-s2.0-57549117044
- Other Identifier
- 991021901515704721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Pharmacology & Pharmacy