Editorial comment

摘要

Many new ideas for the treatment of bladder pain syndrome are proposed every year and few ultimately pan out. The vast majority is accepted for publication prematurely and highlight case reports, anecdotal results, and nonrandomized, small, uncontrolled trials. I think this article should be a model for publication of new treatments. It reveals the results of a small, randomized, double-blind, placebo-controlled trial using low-dose sildenafil for the treatment of non—Hunner lesion bladder pain syndrome in women meeting National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) criteria. Although the numbers are small, the end point parameters are multiple and all but the visual analog pain scale shows a signal that further studies are worthwhile and should be pursued using phosphodiesterase type 5 (PDE5) inhibitors for bladder pain syndrome (BPS). I suspect that the reason that the visual analogue scale scores (VAS) does not suggest efficacy is that the benefits of pain reduction are reflected in the global response, improvements in nocturia and frequency, and urodynamic parameters. Patients modulate their pain by emptying their bladder, and as their pain improves, their voiding intervals would tend to increase, with the pain recurring at similar intensity at a longer interval, which drives micturition. This would not necessarily be judged by the patient as having less pain intensity.