İnterstisyel Sistit/Ağrılı Mesane Sendromunda Tedavi Yönetimi

Aim: Bladder pain syndrome is a chronic disease with unknown etiology and treatment of the disease has not been clearly defined. Any curative treatment choice does not exist for bladder pain syndrome. Various medical treatment choices have been introduced but treatment is usually performed specifically and empirically. Alternative treatment strategies and/or treaatment combinations may be selected. In our study, we aimed to evaluate the treatment strategies and success for bladder pain syndrome. Material and Methods: The medical records of 47 patients diagnosed with bladder pain syndrome between January 2008 and June 2015 have been investigated retrospectively. Patients who have been treated first at our clinic and who have received amitriptyline, pentosan polysulphate (PPS), hydrodystension (HD), intracavitary dimethylsulphoxyde (DMSO) and intracavitary botulinum toxin (BTI) injection treatment together with supportive treatment have been included to the study. Twelve patients who have not completed follow-up course following treatment and 9 patients who have received treatment before have been excluded. Patient satisfaction and higher than 50% decrease in visual analog score (VAS) have been accepted as treatment success. Results: Mean age of 26 patients was 42,8±10,2 (32-59). Five of 26 patients who have received conservative treatment and amitriptyline treatment gained benefit from treatment. Twelve of 26 patients have not received PPS treatment and 14 patients have received PPS treatment. Of these 14 patients, 3 of them have improved. HD treatment has been proposed to 11 patients, 3 of 7 patients who have received HD treatment have improved. Two of 4 patients who have received intracavitary DMSO treatment have gained benefit from the treatment. Two of 4 patients who have received intracavitary BTI treatment have gained benefit from the treatment. Eleven of 26 patients have not improved following any of the treatment strategies. Conclusion: Bladder pain syndrome is a chronic disease with worse patient compliance. Low success rates of different tretmant stages worsens the patients’ compliance to the treatment. Patient and clinician awareness for absence of curative treatment modality and knowledge for the fact that some symptomatic improvements mean an already won victory might increase compliance to the treatment.