Matsuoka P K, Haddad J M, Pacetta A M, Baracat E C
Urogynecology Division, Department of Gynecology and Obstetrics, USP, Sao Paulo, Brazil.
Int Urogynecol J. 2012 Sep;23(9):1147-53. doi: 10.1007/s00192-012-1686-2. Epub 2012 May 9.
The objective of the study was to assess the effectiveness of intravesical treatment for painful bladder syndrome (PBS).
A systematic review was performed until December 31, 2010. The selection criteria included only randomized controlled trials of PBS patients who received intravesical treatment. The primary outcomes measures were clinical and urodynamic parameters. Relative risk and mean differences were used for binary and continuous outcomes respectively, with confidence interval of 95%.
The search strategy identified 770; however, only 28 eligible trials met methodological requirements for complete analysis. Altogether, the review included four treatment modalities: resiniferatoxin, Bacillus Calmette-Guérin (BCG), oxybutynin, and alkalinized lidocaine. Meta-analysis of BCG therapy showed improvement in symptoms according to the Wisconsin Interstitial Cystitis Symptom Inventory, but no difference in 24-h urinary frequency.
Meta-analysis showed an improvement exclusively of the symptoms as measured by the Wisconsin Interstitial Cystitis Inventory, but not in 24-h urinary frequency, with BCG therapy. Further randomized clinical trials, including trials of more recent drugs, are required for evaluation of intravesical therapies for PBS.
本研究的目的是评估膀胱内治疗对疼痛性膀胱综合征（PBS）的有效性。
进行了一项截至2010年12月31日的系统评价。选择标准仅包括接受膀胱内治疗的PBS患者的随机对照试验。主要结局指标为临床和尿动力学参数。相对危险度和均值差分别用于二分类和连续性结局，置信区间为95%。
检索策略共识别出770项研究；然而，只有28项符合条件的试验满足完整分析的方法学要求。该评价总共纳入了四种治疗方式：树脂毒素、卡介苗（BCG）、奥昔布宁和碱化利多卡因。卡介苗治疗的荟萃分析显示，根据威斯康星间质性膀胱炎症状量表，症状有所改善，但24小时排尿频率无差异。
荟萃分析表明，卡介苗治疗仅能改善威斯康星间质性膀胱炎量表所测量的症状，而不能改善24小时排尿频率。需要进一步的随机临床试验，包括对更新药物的试验，以评估PBS的膀胱内治疗方法。
