Table 4.
Summary of guideline for IC/BPS treatment options
| Treatment | Grade | Guideline |
|---|---|---|
| Conservative therapies | ||
| Patient education | A | Recommended in all patients |
| Dietary modifications | B | Recommended in all patients |
| Bladder training | B | Recommended in motivated patients |
| Stress management and psychological support | B | Recommended in patients identified with suffering from stress or psychological dysfunction |
| Physiotherapy and massage | B | Recommended in patients with pelvic floor dysfunction |
| Acupuncture | B | Option in motivated patients |
| Trigger point injections | D | Option for patients with trigger point pain |
| Medical therapies | ||
| Amitriptyline | B | Option |
| Cimetidine | B | Option |
| Hydroxyzine | B | Option for patients with allergic phenotypes |
| Oral pentosan polysulfate | D | Option |
| Cyclosporine A | C | Option as a last resort in patients with inflammation |
| Gabapentinoids | C | Option in patients with neuropathic pain |
| Quercetin | C | Option |
| Intravesical dimethysulfoxide | B | Recommended in selected patients |
| Intravesical heparin | C | Recommended in selected patients |
| Intravesical hyaluronic acid | C | Option |
| Intravesical chondroitin sulfate | D | Option |
| Intravesical alkalinized lidocaine | B | Recommended in selected patients |
| Intravesical resiniferatoxin | B | Not recommended |
| Intravesical Bacillus Calmette-Guerin | B | Not recommended |
| Intravesical pentosan polysulfate | C | Option |
| Intravesical oxybutynin | C | Option |
| Minimally invasive surgical procedures | ||
| Hydrodistension | C | Option |
| Treatment of Hunner’s lesions | B | Recommended for patients with identified Hunner’s lesions |
| Botulinum toxin A | C | Option |
| Sacral neuromodulation | C | Option |
| Radical surgery | C | Option in severe, refractory patients as a last resort |
| Phenotype-directed multimodal therapy | B | Recommended for all patients |
IC/BPS: interstitial cystitis/bladder pain syndrome.