PAINFUL BLADDER SYNDROME/INTERSTITIAL CYSTITIS (PBS/IC)- MEDICAL MANAGEMENT OPTIONS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 11
Abstract
BACKGROUND PBS/IC is a chronic pain syndrome of unknown aetiology. It represents a spectrum of disorders rather than one single disease. It is a diagnosis of exclusion. Evidence based treatment strategy is impossible, but conservative oral treatment may be effective in some patients. Limitations- Patients with unremitting frequency, urgency, nocturia, suprapubic pain relieved with voiding were evaluated. Out of 450 patients investigated, 60 patients were selected for the study. Only patients who had fulfilled the NIDDK exclusion and inclusion criteria were included in this present study. Since the study duration was short, we had to limit the sample size for convenience. Objective/Aim- To study the medical management options of painful bladder syndrome/ interstitial cystitis (PBS/IC)- monotherapy versus multimodality therapy. MATERIALS AND METHODS Questionnaire based study was conducted on 450 patients between August 2008 and August 2017. 60 patients were selected for the present study based on National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) inclusion and exclusion criteria for diagnosis of PBS/IC. 54 patients were women and 6 patients were men with a mean age of 44 yrs. and 20% were over 60 yrs. of age. Overall, 48% received pentosan alone and 52% received pentosan plus gabapentin and hydroxyzine. During interview, three questionnaires were administered. One related to pain/ discomfort scores, second overall investigator evaluation after treatment, third efficacy of pentosan alone and in combination with other drugs. Improvement of > 50% was considered as success. RESULTS Combined treatment with hydroxyzine, pentosan and gabapentin showed better clinical response 12 patients (40%) compared to monotherapy with pentosan 9 patients (30%). CONCLUSION Simultaneous multiple drug initiation can yield better results compared to single drug as PBS/IC is a clinical syndrome of multifactorial aetiology
Authors and Affiliations
Guda Manohar, Duppala Radha Krishnan
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