What is the treatment algorithm for interstitial cystitis/bladder pain syndrome (IC/BPS) in patients with significant voiding symptoms?

Updated: Dec 04, 2020
  • Author: Eric S Rovner, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

In patients with significant voiding symptoms, the authors suggest an algorithm proposed by Hanno. Conservative treatment may include patient education, dietary manipulation, nonprescription analgesics, and pelvic floor relaxation. If the improvement in symptoms is inadequate, begin oral therapy either with antispasmodics/antimuscarinics and nonnarcotic analgesics. In addition, a trial of amitriptyline for 8 weeks may be warranted. If amitriptyline fails, a trial of hydroxyzine for 8 weeks is suggested. If no response is observed, follow hydroxyzine with pentosan polysulfate sodium.


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