Best Practice Guideline for Managing Interstitial Cystitis in Adult Women.

摘要

Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic disease characterized by symptoms of urinary urgency, frequency, bladder pain, and chronic pelvic pain in the absence of known pathology. Selection of appropriate treatments depended on the severity of the patient's symptoms and patient's preference. This review found that it is important for providers and patients to set realistic goals for symptom improvement when starting a new treatment.;The purposes of this project was to 1) conduct a substantive literature review on treatment guidelines for IC/PBS, 2) analyze the literature for comparing oral pharmacological interventions and behavioral interventions for IC/PBS, and 3) determine the best practice recommendation for the management of ICS/PBS in adult women. An extensive review and analysis of literature published from 2002 through 2012 was conducted to answer the following PICOT question: In women ages 18 and older with a diagnosis of IC/PBS, who are not pregnant (P), how do oral pharmacological interventions (I) compare with behavioral interventions (C) Best practice for managing IC/PBS in adult women ages 18 and older, evidenced by a decrease in IC/PBS symptoms indicated by a reduction in the patient's ICSI and ICPI scores from baseline or patient self reported improvement of symptoms. (T)?;Best practice management of IC/PBS begins by setting realistic goals with the patient for adequate symptom control and quality of life. The literature showed that behavioral modification and adequate coping strategies significantly improve symptoms and quality of life for women with IC/PBS (Chaiken et al., 1993; Rothrock et al., 2003). The literature did not support the use of amitptyline, cimetidine, or hydroxyzine for management of symptoms of IC/PBS in women (Dimitrakov et al., 2007; Hill et al., 2008; Unwin, 2011). RCTs and systematic reviews found that PPS significantly improved symptoms of IC/PBS and quality of life with minimal side effects and the medication was generally well tolerated (Dimitrakov et al., 2007; Nickel et al., 2005; Nickel et al., 2008; Sand et al., 2008). Management of IC/PBS should focus on providing adequate relief to the patient with the most conservative treatments possible.