Pazin Carolina, de Souza Mitidieri Andréia Moreira, Silva Ana Paula Moreira, Gurian Maria Beatriz Ferreira, Poli-Neto Omero Benedicto, Rosa-E-Silva Julio Cesar
Department of Gynecology and Obstetrics, Faculty of Medicine, University of São Paulo, Av. Bandeirantes, 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil.
Int Urogynecol J. 2016 May;27(5):697-708. doi: 10.1007/s00192-015-2815-5. Epub 2015 Aug 14.
Bladder pain syndrome/interstitial cystitis (BPS/IC) has various treatments; however, no standardized treatment has been established. The aim was to analyze different types of treatment of BPS/IC and their effectiveness.
A literature review with a search strategy for articles related to BPS/IC published between 1990 and 2014 was conducted on MEDLINE, PUBMED, and SCOPUS. Only randomized controlled trials in women were included in the meta-analysis, while other experimental studies were used as bases for a systematic review of the topic. Clinical trial quality was defined according to the Jadad scale.
Of 356 articles, 13 were included in the analysis. The intervention methods were as follows: instillation of hyaluronic acid, botulinum toxin A, intravesical lidocaine, hyperbaric chamber, massage, physiotherapy, phosphate-buffered saline, piroxicam in combination with doxepin, and others. We did not find any treatment with at least two randomized controlled trials for meta-analysis. Among the assessment tools for symptoms of BPS/IC, the most frequently used were the visual analogue scale, voiding record, and the O'Leary-Sant questionnaire.
Existing studies were not able to define the best approach for the treatment of BPS/IC. The lack of standardized treatment may be related to the diversity of interventions used; therefore, further studies with better methodological quality are needed.
膀胱疼痛综合征/间质性膀胱炎(BPS/IC)有多种治疗方法;然而,尚未确立标准化治疗方案。本研究旨在分析BPS/IC的不同治疗类型及其有效性。
在MEDLINE、PUBMED和SCOPUS数据库中进行文献综述,搜索1990年至2014年发表的与BPS/IC相关的文章。荟萃分析仅纳入女性的随机对照试验,而其他实验性研究则作为该主题系统评价的基础。根据Jadad量表定义临床试验质量。
在356篇文章中,13篇被纳入分析。干预方法如下:透明质酸灌注、肉毒杆菌毒素A、膀胱内利多卡因、高压氧舱、按摩、物理治疗、磷酸盐缓冲盐水、吡罗昔康联合多塞平以及其他方法。我们未发现有任何一种治疗方法有至少两项随机对照试验可供荟萃分析。在BPS/IC症状评估工具中,最常用的是视觉模拟量表、排尿记录和O'Leary-Sant问卷。
现有研究无法确定BPS/IC的最佳治疗方法。缺乏标准化治疗可能与所使用干预措施的多样性有关;因此,需要开展方法学质量更高的进一步研究。