The Use of Pentosan Polysulfate in the Management of Interstitial Cystitis

  • Robert M. MoldwinEmail author


“Interstitial Cystitis” was published in 1988 by Springer Verlag, and was one of the earliest publications detailing the potential role of pentosan polysulfate for the treatment of interstitial cystitis [1]. In an earlier pilot study, Parsons et al., described that this sulfated polysaccharide could improve symptoms in 90% of interstitial cystitis patients [2]. The textbook chapter that followed described the theoretical basis of pentosan polysulfate’s (PPS) action along with data developed from a placebo controlled double-blinded cross over study. Results were not quite as spectacular, but nevertheless promising with 47% of PPS treated patients reporting overall symptom improvement compared to 23% of those receiving placebo. Over the past 35 years, our use of PPS in IC therapy has evolved based upon newer literature and the clinical experience of dedicated practitioners.


  1. 1.
    Parsons CL. Interstitial cystitis. Use of pentosan polysulfate in the management of interstitial cystitis. In: Hanno PM, Staskin DR, Krane RJ, Wein AJ, editors. Interstitial cystitis (chapter 17). London: Springer; 1988. p. 163–8.Google Scholar
  2. 2.
    Parsons CL, Schmidt JD, Pollen JJ. Successful treatment of interstitial cystitis with sodium pentosanpolysulfate. J Urol. 1983;130:51–3.CrossRefPubMedGoogle Scholar
  3. 3.
  4. 4.
    Gillenwater JY, Wein AJ. Summary of the National Institute of arthritis, diabetes, digestive and kidney diseases workshop on interstitial cystitis, National Institutes of Health, Bethesda, Maryland, August 28-29, 1987. J Urol. 1988;140:203–6.CrossRefPubMedGoogle Scholar
  5. 5.
    Parsons CL, Mulholland SG. Successful therapy of interstitial cystitis with pentosanpolysulfate. J Urol. 1987;138:513–6.CrossRefPubMedGoogle Scholar
  6. 6.
    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;138:503–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Fritjofsson A, Fall M, Juhlin R, et al. Treatment of ulcer and nonulcer interstitial cystitis with sodium pentosanpolysulfate: a multicenter trial. J Urol. 1987;138:508–12.CrossRefPubMedGoogle Scholar
  8. 8.
    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;35:552–8.CrossRefPubMedGoogle Scholar
  9. 9.
    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;150:845–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Hanno PM. Analysis of long-term Elmiron therapy for interstitial cystitis. Urology. 1997;49:93–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Jepsen JV, Sall M, Rhodes PR, et al. Long-term experience with pentosanpolysulfate in interstitial cystitis. Urology. 1998;51:381–7.CrossRefPubMedGoogle Scholar
  12. 12.
    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;170:810–5.CrossRefPubMedGoogle Scholar
  13. 13.
    Nickel JC, Barkin J, Forrest J, et al. Randomized, double-blind, dose-ranging study of pentosan polysulfate sodium for interstitial cystitis. Urology. 2005;65:654–8.CrossRefPubMedGoogle Scholar
  14. 14.
    Nickel JC, Kaufman DM, Zhang HF, et al. Time to initiation of pentosan polysulfate sodium treatment after interstitial cystitis diagnosis: effect on symptom improvement. Urology. 2008;71:57–61.CrossRefPubMedGoogle Scholar
  15. 15.
    Davis EL, Khoudary el SR, Talbott EO, et al. Safety and efficacy of the use of intravesical and oral pentosan polysulfate sodium for interstitial cystitis: a randomized double-blind clinical trial. J Urol. 2008;179:177–85.CrossRefPubMedGoogle Scholar
  16. 16.
    Al-Zahrani AA, Gajewski JB. Long-term efficacy and tolerability of pentosan polysulphate sodium in the treatment of bladder pain syndrome. Can Urol Assoc J. 2011;5:113–8.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Nickel JC, Herschorn S, Whitmore KE, et al. Pentosan polysulfate sodium for treatment of interstitial cystitis/bladder pain syndrome: insights from a randomized, double-blind, placebo controlled study. J Urol. 2015;193:857–62.CrossRefPubMedGoogle Scholar
  18. 18.
    Propert KJ, Payne C, Kusek JW, Nyberg LM. Pitfalls in the design of clinical trials for interstitial cystitis. Urology. 2002;60:742–8.CrossRefPubMedGoogle Scholar
  19. 19.
    Stephens-Shields AJ, Clemens JQ, Jemielita T, et al. Symptom variability and early symptom regression in the MAPP study: a prospective study of urological chronic pelvic pain syndrome. J Urol. 2016;196:1450–5.CrossRefPubMedGoogle Scholar
  20. 20.
    Griffith JW, Stephens-Shields AJ, Hou X, et al. Pain and urinary symptoms should not be combined into a single score: psychometric findings from the MAPP research network. J Urol. 2016;195:949–54.CrossRefPubMedGoogle Scholar
  21. 21.
    Nickel JC, Tripp DA, Pontari M, et al. Interstitial cystitis/painful bladder syndrome and associated medical conditions with an emphasis on irritable bowel syndrome, fibromyalgia and chronic fatigue syndrome. J Urol. 2010;184:1358–63.CrossRefPubMedGoogle Scholar
  22. 22.
    Nickel JC, Tripp DA, International Interstitial Cystitis Study Group. Clinical and psychological parameters associated with pain pattern phenotypes in women with interstitial cystitis/bladder pain syndrome. J Urol. 2015;193:138–44.CrossRefPubMedGoogle Scholar
  23. 23.
    Krieger JN, Stephens AJ, Clemens JQ, et al. Relationship between chronic nonurological associated somatic syndromes and symptom severity in urological chronic pelvic pain syndromes: baseline evaluation of the MAPP study. J Urol. 2015;193:1254–62.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Hofstra Northwell School of Medicine, Pelvic Pain Treatment CenterThe Arthur Smith Institute for UrologyLake SuccessUSA

Personalised recommendations