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Treatment Approaches for Painful Bladder Syndrome/Interstitial Cystitis

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Abstract

Painful bladder syndrome/interstitial cystitis (PBS/IC) is a disease of unknown aetiology, characterised by severe pressure and pain in the bladder area or lower pelvis that is frequently or typically relieved by voiding, along with urgency or frequency of urination in the absence of urinary tract infections. PBS/IC occurs primarily in women, is increasingly recognised in young adults, and may affect as many as 0.1–1% of adult women. PBS/IC is often comorbid with allergies, endometriosis, fibromyalgia, irritable bowel syndrome and panic syndrome, all of which are worsened by stress. As a result, patients may visit as many as five physicians, including family practitioners, internists, gynaecologists, urologists and pain specialists, leading to confusion and frustration. There is no curative treatment; intravesical dimethyl sulfoxide, as well as oral amitriptyline, pentosan polysulfate and hydroxyzine have variable results, with success more likely when these drugs are given together. Pilot clinical trials suggest that the flavonoid quercetin may be helpful. Lack of early diagnosis and treatment can affect outcomes and leads to the development of hyperalgesia/allodynia.

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Acknowledgements

Thanks are due to Ms Jessica Christian for her patience and word-processing skills. Aspects of our own research have been funded by the Interstitial Cystitis Association, as well as NIH grants No. DK42409, DK44816, DK62861, NS38326 and AR47652. We have also participated in the Interstitial Cystitis Clinical Trials Group funded by DK54133 (Principal Investigator: Dr GR Sant, Co-Principal Investigator: Dr TC Theoharides), and in the Interstitial Cystitis Clinical Research Network funded by DK65244 (Principal Investigator: Dr GR Sant, Co-Investigator: Dr TC Theoharides).

Dr TC Theoharides has been awarded Patents No. US 5,994,357; US 6,635,625; US 6,641,806; US 6,689,748; US No. 6,984,667 and European Patent Office No. 1365777 and is awaiting a decision on US patent 10/811,839 for Painful Bladder Syndrome/Interstitial Cystitis and related inflammatory disorders. Dr TC Theoharides owns stock in Algonot, LLC (Sarasota, FL).

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  1. Department of Pharmacology and Experimental Therapeutics, Biochemistry and Internal Medicine, Tufts University School of Medicine, Tufts-New England Medical Center, 136 Harrison Avenue, Boston, Massachusetts, 02111, USA

    Theoharis C. Theoharides

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Theoharides, T.C. Treatment Approaches for Painful Bladder Syndrome/Interstitial Cystitis. Drugs 67, 215–235 (2007). https://doi.org/10.2165/00003495-200767020-00004

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