What are the treatment options for patients with interstitial cystitis?
Because the etiology of interstitial cystitis remains unknown and the pathogenesis has not been clarified, the current treatment focuses on decreasing symptoms and achieving remission. Various types of pharmacotherapy and surgical manipulations have been tried with varying degrees of success. Among the latter, cystoscopic hydrodistention may provide only temporary relief, and cystectomy and urinary diversion have an unacceptable high failure rate for pain control. Standard pharmacotherapy with a tricyclic antidepressant (amitriptyline), intravesical dimethylsulfoxide, anticholinergics, antihistamines, cyclosporin A, and pentosan polysulfate sodium has been tested with some effects but also often with significant side effects. Although at this time all encouraging data are limited to animal studies, antineuropeptide therapy appears to offer the best hope. According to recent studies, neuromodulation via direct stimulation of the sacral nerves is another approach with lasting favorable results.
KeywordsInterstitial Cystitis Sacral Nerve Stimulation Pentosan Polysulfate Sacral Nerve Root Pontine Micturition Center
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