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Interstitial Cystitis/painful Bladder Syndrome (interstitial + painful_bladder_syndrome)
Selected AbstractsORIGINAL RESEARCH,SEXUAL PAIN DISORDERS: Interstitial Cystitis/Painful Bladder Syndrome as a Cause of Sexual Pain in Women: A Diagnosis to ConsiderTHE JOURNAL OF SEXUAL MEDICINE, Issue 3 2007Kristene Whitmore MD ABSTRACT Introduction., Sexual pain, or dyspareunia, is a common symptom among women. Dyspareunia presents in many ways, and arises from a range of causes. Interstitial cystitis/painful bladder syndrome (IC/PBS) is one potential cause that may frequently be overlooked by clinicians. Interstitial cystitis is increasingly recognized as more common than was once thought. However, it can be difficult to identify, as the symptoms of IC/PBS (urinary urgency and frequency, dyspareunia, nocturia, and pelvic pain) overlap with other urogynecologic conditions. Aim., This article will review the association between dyspareunia and IC/PBS, and will provide an approach to the diagnosis and treatment of IC/PBS in women with sexual pain. Methods and Main Outcome Measures., Review of the medical literature and expert medical opinion. Results., Many women with IC/PBS experience dyspareunia, often in conjunction with chronic pelvic pain. When IC/PBS is suspected, there are simple measures to aid in the diagnosis of this condition, and treatments are readily available. Conclusions., When a woman presents with the symptoms of urinary urgency and frequency, dyspareunia, nocturia, and/or pelvic pain, IC/PBS should be part of the diagnostic evaluation. Whitmore K, Siegel JF, and Kellogg-Spadt S. Interstitial cystitis/painful bladder syndrome as a cause of sexual pain in women: A diagnosis to consider. J Sex Med 2007;4:720,727. [source] Intravesical alkalinized lidocaine (PSD597) offers sustained relief from symptoms of interstitial cystitis and painful bladder syndromeBJU INTERNATIONAL, Issue 7 2009J. Curtis Nickel OBJECTIVE To assess the immediate and sustained relief of the symptoms of interstitial cystitis/painful bladder syndrome (IC/PBlS) after a consecutive 5-day course of treatment with intravesical alkalinized lidocaine (PSD597), and to characterize the pharmacokinetics of single and multiple doses of intravesical PSD597 in a subgroup of patients. PATIENTS AND METHODS In all, 102 adult patients (99 women) with a clinical diagnosis of IC/PBlS were randomized from 19 centres in the USA and Canada to receive a daily intravesical instillation of PSD597 (200 mg lidocaine, alkalinized with a sequential instillation of 8.4% sodium bicarbonate solution, to a final volume of 10 mL) or placebo (double-blind), for 5 consecutive days. Patients were followed at intervals up to 29 days after the first instillation. Efficacy was assessed by changes in the Global Response Assessment (GRA), Likert scales for bladder pain, urgency and frequency, and validated O'Leary-Sant IC symptom and problem indices. RESULTS Significantly more patients treated with PSD597 rated their overall bladder symptoms as moderately or markedly improved on the GRA scale 3 days after completing the 5-day course of treatment (30% and 9.6%, respectively, for patients treated with PSD597 and placebo; P = 0.012). The treatment effects were also maintained beyond the end of treatment and are further supported by the secondary endpoints, including symptom and problem indices. The peak serum lidocaine concentration during the study was <2 µg/mL, and well below the toxic level (>5 µg/mL). CONCLUSION This preliminary study showed that PSD597 was effective for providing sustained amelioration of symptoms of IC/PBlS beyond the acute treatment phase. The drug was safe, well tolerated and devoid of the systemic side-effects often experienced with oral drug administration. Long-term studies are needed to determine the optimum regimen to maintain this favourable treatment effect. [source] | ||||||||||