What are the components of the work up for interstitial cystitis or bladder pain syndrome in both males and females after you’ve completed the physical examination?
- voiding diary
- Validated questionnaire
- UA/uCx
- Cytology if the patient is high risk
- UF/PVR
- Consider UDS
- Consider Cysto
- Consider imaging
What is the first line in management of interstitial cystitis or bladder pain syndrome in men and women?
- Education
- Pain management
- Lifestyle modification including fluid restriction and avoidance of bladder irritants
- Stress reduction
What is second in line therapy in the management of interstitial cystitis or bladder pain syndrome in men and women?
- Oral medications include hydroxyzine, cimetidine, amitriptyline, or Elmiron
- Lidocaine/heparin/DMSO instillation
- Physical therapy
What are the third line therapies for interstitial cystitis or bladder pain syndrome in both men and women?
If hunters ulcers are present, a cystoscopy with hydrodistention and fold ration
What our fourth line therapies for interstitial cystitis bladder pain syndrome in both men and women?
Botox or PTNS or Sacral Neuromodulation But none of these are FDA approved
What are the fifth line therapies?
Cyclosporine A
What are 6th line therapies?
CYSTectomy, diversion, augment
SEs of amitriptylene
drowsy
Cimetidine
Headaches, dizziness, diarrhea
SE of hydroxyxine
dry mouth, drowsiness, dizziness
SEs of elmiron
Rectal bleeding, alopecia, diarrhea
