Skip to main content
Top
Published in: Current Urology Reports 6/2010

01-11-2010

Overactive Bladder and Pain: Management Strategies

Authors: Bhavin N. Patel, Robert J. Evans

Published in: Current Urology Reports | Issue 6/2010

Login to get access

Abstract

Overactive bladder associated with pain (ie, interstitial cystitis/bladder pain syndrome [IC/BPS]) is a prevalent condition that can be very difficult to diagnose and even more difficult to treat. In this paper, we review the studied therapies for IC/BPS, including non–medication-based therapies, oral and intravesical-based medications, and surgical treatments for interstitial cystitis. We also review an approach to the treatment of a patient with IC/BPS using the previously published UPOINT clinical phenotyping template.
Literature
1.
go back to reference • Hanno P, Dmochowski R: Status of international consensus on interstitial cystitis/bladder pain syndrome/painful bladder syndrome: 2008 snapshot. Neurourol Urodyn 2009, 28:274–286. This is an article of importance because it outlines the inherent difficulties in defining and naming a condition that is broad in its symptomatology . CrossRefPubMed • Hanno P, Dmochowski R: Status of international consensus on interstitial cystitis/bladder pain syndrome/painful bladder syndrome: 2008 snapshot. Neurourol Urodyn 2009, 28:274–286. This is an article of importance because it outlines the inherent difficulties in defining and naming a condition that is broad in its symptomatology . CrossRefPubMed
2.
go back to reference Whitmore KE: Self-care regimens for patients with interstitial cystitis. Urol Clin North Am 1994, 21:121–130.PubMed Whitmore KE: Self-care regimens for patients with interstitial cystitis. Urol Clin North Am 1994, 21:121–130.PubMed
3.
go back to reference Whitmore KE: Complementary and alternative therapies as treatment approaches for interstitial cystitis. Rev Urol 2002, 4(Suppl 1):S28–S35.PubMed Whitmore KE: Complementary and alternative therapies as treatment approaches for interstitial cystitis. Rev Urol 2002, 4(Suppl 1):S28–S35.PubMed
4.
go back to reference • Foster HE Jr, Hanno PM, Nickel JC, et al.: Effect of amitriptyline on symptoms in treatment naïve patients with interstitial cystitis/painful bladder syndrome. J Urol 2010, 183:1853–1858. This study shows the importance of standardized education and behavioral modification in patients with IC/BPS.CrossRefPubMed • Foster HE Jr, Hanno PM, Nickel JC, et al.: Effect of amitriptyline on symptoms in treatment naïve patients with interstitial cystitis/painful bladder syndrome. J Urol 2010, 183:1853–1858. This study shows the importance of standardized education and behavioral modification in patients with IC/BPS.CrossRefPubMed
5.
go back to reference • FitzGerald MP, Anderson RU, Potts J, et al.: Randomized multicenter feasibility trial of myofascial physical therapy for the treatment of urological chronic pelvic pain syndromes. J Urol 2009, 182:570–580. This is an important study demonstrating the relative effectiveness of myofascial physical therapy compared to therapeutic message in relieving symptoms of IC/BPS.CrossRefPubMed • FitzGerald MP, Anderson RU, Potts J, et al.: Randomized multicenter feasibility trial of myofascial physical therapy for the treatment of urological chronic pelvic pain syndromes. J Urol 2009, 182:570–580. This is an important study demonstrating the relative effectiveness of myofascial physical therapy compared to therapeutic message in relieving symptoms of IC/BPS.CrossRefPubMed
6.
go back to reference Rapkin AJ, Kames LD: The pain management approach to chronic pelvic pain. J Reprod Med 1987, 32:323–327.PubMed Rapkin AJ, Kames LD: The pain management approach to chronic pelvic pain. J Reprod Med 1987, 32:323–327.PubMed
7.
go back to reference Geirsson G, Wang YH, Lindström S, Fall M: Traditional acupuncture and electrical stimulation of the posterior tibial nerve. A trial in chronic interstitial cystitis. Scand J Urol Nephrol 1993, 27:67–70. Geirsson G, Wang YH, Lindström S, Fall M: Traditional acupuncture and electrical stimulation of the posterior tibial nerve. A trial in chronic interstitial cystitis. Scand J Urol Nephrol 1993, 27:67–70.
8.
go back to reference Mulholland SG, Hanno P, Parsons CL, et al.: Pentosan polysulfate sodium for therapy of interstitial cystitis. A double-blind placebo-controlled clinical study. Urology 1990, 35:552–558. Mulholland SG, Hanno P, Parsons CL, et al.: Pentosan polysulfate sodium for therapy of interstitial cystitis. A double-blind placebo-controlled clinical study. Urology 1990, 35:552–558.
9.
go back to reference Parsons CL, Benson G, Childs SJ, et al.: A quantitatively controlled method to study prospectively interstitial cystitis and demonstrate the efficacy of pentosanpolysulfate. J Urol 1993, 150:845–848.PubMed Parsons CL, Benson G, Childs SJ, et al.: A quantitatively controlled method to study prospectively interstitial cystitis and demonstrate the efficacy of pentosanpolysulfate. J Urol 1993, 150:845–848.PubMed
10.
go back to reference Sant GR, Propert KJ, Hanno PM, et al.: A pilot clinical trial of oral pentosan polysulfate and oral hydroxyzine in patients with interstitial cystitis. J Urol 2003, 170:810–815.CrossRefPubMed Sant GR, Propert KJ, Hanno PM, et al.: A pilot clinical trial of oral pentosan polysulfate and oral hydroxyzine in patients with interstitial cystitis. J Urol 2003, 170:810–815.CrossRefPubMed
11.
go back to reference Holm-Bentzen M, Jacobsen F, Nerstrøm B, et al.: A prospective double-blind clinically controlled multicenter trial of sodium pentosanpolysulfate in the treatment of interstitial cystitis and related painful bladder disease. J Urol 1987, 138:503–507.PubMed Holm-Bentzen M, Jacobsen F, Nerstrøm B, et al.: A prospective double-blind clinically controlled multicenter trial of sodium pentosanpolysulfate in the treatment of interstitial cystitis and related painful bladder disease. J Urol 1987, 138:503–507.PubMed
12.
go back to reference Thilagarajah R, Witherow RO, Walker MM: Oral cimetidine gives effective symptom relief in painful bladder disease: a prospective, randomized, double-blind placebo-controlled trial. BJU Int 2001, 87:207–212.CrossRefPubMed Thilagarajah R, Witherow RO, Walker MM: Oral cimetidine gives effective symptom relief in painful bladder disease: a prospective, randomized, double-blind placebo-controlled trial. BJU Int 2001, 87:207–212.CrossRefPubMed
13.
go back to reference Seshadri P, Emerson L, Morales A: Cimetidine in the treatment of interstitial cystitis. Urology 1994, 44:614–616.CrossRefPubMed Seshadri P, Emerson L, Morales A: Cimetidine in the treatment of interstitial cystitis. Urology 1994, 44:614–616.CrossRefPubMed
14.
go back to reference Dasgupta P, Sharma SD, Womack C, et al.: Cimetidine in painful bladder syndrome: a histopathological study. BJU Int 2001, 88:183–186.CrossRefPubMed Dasgupta P, Sharma SD, Womack C, et al.: Cimetidine in painful bladder syndrome: a histopathological study. BJU Int 2001, 88:183–186.CrossRefPubMed
15.
go back to reference Minogiannis P, El-Mansoury M, Betances JA, et al.: Hydroxyzine inhibits neurogenic bladder mast cell activation. Int J Immunopharmacol 1998, 20:553–563.CrossRefPubMed Minogiannis P, El-Mansoury M, Betances JA, et al.: Hydroxyzine inhibits neurogenic bladder mast cell activation. Int J Immunopharmacol 1998, 20:553–563.CrossRefPubMed
16.
go back to reference Theoharides TC: Hydroxyzine in the treatment of interstitial cystitis. Urol Clin North Am 1994, 21:113–119.PubMed Theoharides TC: Hydroxyzine in the treatment of interstitial cystitis. Urol Clin North Am 1994, 21:113–119.PubMed
17.
go back to reference Theoharides TC, Sant GR: Hydroxyzine therapy for interstitial cystitis. Urology 1997, 49(5A Suppl):108–110. Theoharides TC, Sant GR: Hydroxyzine therapy for interstitial cystitis. Urology 1997, 49(5A Suppl):108–110.
18.
go back to reference van Ophoven A, Pokupic S, Heinecke A, Hertle L: A prospective, randomized, placebo controlled, double-blind study of amitriptyline for the treatment of interstitial cystitis. J Urol 2004, 172:533–536.CrossRefPubMed van Ophoven A, Pokupic S, Heinecke A, Hertle L: A prospective, randomized, placebo controlled, double-blind study of amitriptyline for the treatment of interstitial cystitis. J Urol 2004, 172:533–536.CrossRefPubMed
19.
go back to reference Sairanen J, Forsell T, Ruutu M: Long-term outcome of patients with interstitial cystitis treated with low dose cyclosporine A. J Urol 2004, 171:2138–2141.CrossRefPubMed Sairanen J, Forsell T, Ruutu M: Long-term outcome of patients with interstitial cystitis treated with low dose cyclosporine A. J Urol 2004, 171:2138–2141.CrossRefPubMed
20.
go back to reference Sairanen J, Tammela TL, Leppilahti M, et al.: Cyclosporine A and pentosan polysulfate sodium for the treatment of interstitial cystitis: a randomized comparative study. J Urol 2005, 174:2235–2238.CrossRefPubMed Sairanen J, Tammela TL, Leppilahti M, et al.: Cyclosporine A and pentosan polysulfate sodium for the treatment of interstitial cystitis: a randomized comparative study. J Urol 2005, 174:2235–2238.CrossRefPubMed
21.
go back to reference Parsons CL: Successful downregulation of bladder sensory nerves with combination of heparin and alkalinized lidocaine in patients with interstitial cystitis. Urology 2005, 65:45–48.CrossRefPubMed Parsons CL: Successful downregulation of bladder sensory nerves with combination of heparin and alkalinized lidocaine in patients with interstitial cystitis. Urology 2005, 65:45–48.CrossRefPubMed
22.
go back to reference • Welk BK, Teichman JM: Dyspareunia response in patients with interstitial cystitis treated with intravesical lidocaine, bicarbonate, and heparin. Urology 2008, 71:67–70. This study demonstrates the positive effects of intravesical therapy on sexual function and pain in patients with IC.CrossRefPubMed • Welk BK, Teichman JM: Dyspareunia response in patients with interstitial cystitis treated with intravesical lidocaine, bicarbonate, and heparin. Urology 2008, 71:67–70. This study demonstrates the positive effects of intravesical therapy on sexual function and pain in patients with IC.CrossRefPubMed
23.
go back to reference Nickel JC, Moldwin R, Lee S, et al.: Intravesical alkalinized lidocaine (PSD597) offers sustained relief from symptoms of interstitial cystitis and painful bladder syndrome. BJU Int 2009, 103:910–918.CrossRefPubMed Nickel JC, Moldwin R, Lee S, et al.: Intravesical alkalinized lidocaine (PSD597) offers sustained relief from symptoms of interstitial cystitis and painful bladder syndrome. BJU Int 2009, 103:910–918.CrossRefPubMed
24.
go back to reference Parsons CL, Housley T, Schmidt JD, Lebow D: Treatment of interstitial cystitis with intravesical heparin. Br J Urol 1994, 73:504–507.CrossRefPubMed Parsons CL, Housley T, Schmidt JD, Lebow D: Treatment of interstitial cystitis with intravesical heparin. Br J Urol 1994, 73:504–507.CrossRefPubMed
25.
go back to reference Aihara K, Hirayama A, Tanaka N, et al.: Hydrodistension under local anesthesia for patients with suspected painful bladder syndrome/interstitial cystitis: safety, diagnostic potential and therapeutic efficacy. Int J Urol 2009, 16:947–952.CrossRefPubMed Aihara K, Hirayama A, Tanaka N, et al.: Hydrodistension under local anesthesia for patients with suspected painful bladder syndrome/interstitial cystitis: safety, diagnostic potential and therapeutic efficacy. Int J Urol 2009, 16:947–952.CrossRefPubMed
26.
go back to reference Ottem DP, Teichman JM: What is the value of cystoscopy with hydrodistension for interstitial cystitis? Urology 2005, 66:494–499.CrossRefPubMed Ottem DP, Teichman JM: What is the value of cystoscopy with hydrodistension for interstitial cystitis? Urology 2005, 66:494–499.CrossRefPubMed
27.
go back to reference Peeker R, Aldenborg F, Fall M: Complete transurethral resection of ulcers in classic interstitial cystitis. Int Urogynecol J Pelvic Floor Dysfunct 2000, 11:290–295.CrossRefPubMed Peeker R, Aldenborg F, Fall M: Complete transurethral resection of ulcers in classic interstitial cystitis. Int Urogynecol J Pelvic Floor Dysfunct 2000, 11:290–295.CrossRefPubMed
28.
go back to reference Rofeim O, Hom D, Freid RM, Moldwin RM: Use of the neodymium: YAG laser for interstitial cystitis: a prospective study. J Urol 2001, 166:134–136.CrossRefPubMed Rofeim O, Hom D, Freid RM, Moldwin RM: Use of the neodymium: YAG laser for interstitial cystitis: a prospective study. J Urol 2001, 166:134–136.CrossRefPubMed
29.
go back to reference Cox M, Klutke JJ, Klutke CG: Assessment of patient outcomes following submucosal injection of triamcinolone for treatment of Hunner's ulcer subtype interstitial cystitis. Can J Urol 2009, 16:4536–4540.PubMed Cox M, Klutke JJ, Klutke CG: Assessment of patient outcomes following submucosal injection of triamcinolone for treatment of Hunner's ulcer subtype interstitial cystitis. Can J Urol 2009, 16:4536–4540.PubMed
30.
go back to reference • Pinto R, Lopes T, Frias B, et al.: Trigonal Injection of Botulinum Toxin A in Patients with Refractory Bladder Pain Syndrome/Interstitial Cystitis. Eur Urol 2010 Mar 6 (Epub ahead of print). This observational study documents the positive effect and the length of effect on voiding parameters of trigonal botulinum toxin in patients with IC. • Pinto R, Lopes T, Frias B, et al.: Trigonal Injection of Botulinum Toxin A in Patients with Refractory Bladder Pain Syndrome/Interstitial Cystitis. Eur Urol 2010 Mar 6 (Epub ahead of print). This observational study documents the positive effect and the length of effect on voiding parameters of trigonal botulinum toxin in patients with IC.
31.
go back to reference Gottsch HP, Miller JL, Yang CC, Berger RE: A pilot study of botulinum toxin for interstitial cystitis/painful bladder syndrome. Neurourol Urodyn 2010 Jun 29 (Epub ahead of print). Gottsch HP, Miller JL, Yang CC, Berger RE: A pilot study of botulinum toxin for interstitial cystitis/painful bladder syndrome. Neurourol Urodyn 2010 Jun 29 (Epub ahead of print).
32.
go back to reference Comiter CV: Sacral neuromodulation for the symptomatic treatment of refractory interstitial cystitis: a prospective study. J Urol 2003, 169:1369–1373.CrossRefPubMed Comiter CV: Sacral neuromodulation for the symptomatic treatment of refractory interstitial cystitis: a prospective study. J Urol 2003, 169:1369–1373.CrossRefPubMed
33.
go back to reference Lotenfoe RR, Christie J, Parsons A, et al.: Absence of neuropathic pelvic pain and favorable psychological profile in the surgical selection of patients with disabling interstitial cystitis. J Urol 1995, 154:2039–2042.CrossRefPubMed Lotenfoe RR, Christie J, Parsons A, et al.: Absence of neuropathic pelvic pain and favorable psychological profile in the surgical selection of patients with disabling interstitial cystitis. J Urol 1995, 154:2039–2042.CrossRefPubMed
34.
go back to reference •• Shoskes DA, Nickel JC, Kattan MW: Phenotypically directed multimodal therapy for chronic prostatitis/chronic pelvic pain syndrome: a prospective study using UPOINT. Urology 2010, 75:1249–1253. This is a paper of major importance because it provides a practical algorithm for the evaluation of patients with IC/BPS.CrossRefPubMed •• Shoskes DA, Nickel JC, Kattan MW: Phenotypically directed multimodal therapy for chronic prostatitis/chronic pelvic pain syndrome: a prospective study using UPOINT. Urology 2010, 75:1249–1253. This is a paper of major importance because it provides a practical algorithm for the evaluation of patients with IC/BPS.CrossRefPubMed
Metadata
Title
Overactive Bladder and Pain: Management Strategies
Authors
Bhavin N. Patel
Robert J. Evans
Publication date
01-11-2010
Publisher
Current Science Inc.
Published in
Current Urology Reports / Issue 6/2010
Print ISSN: 1527-2737
Electronic ISSN: 1534-6285
DOI
https://doi.org/10.1007/s11934-010-0141-5

Other articles of this Issue 6/2010

Current Urology Reports 6/2010 Go to the issue