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Practice Guideline
. 2011 Jun;185(6):2162-70.
doi: 10.1016/j.juro.2011.03.064. Epub 2011 Apr 16.

AUA guideline for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome

Philip M Hanno  1 , David Allen Burks, J Quentin Clemens, Roger R Dmochowski, Deborah Erickson, Mary Pat Fitzgerald, John B Forrest, Barbara Gordon, Mikel Gray, Robert Dale Mayer, Diane Newman, Leroy Nyberg Jr, Christopher K Payne, Ursula Wesselmann, Martha M Faraday; Interstitial Cystitis Guidelines Panel of the American Urological Association Education and Research, Inc
Collaborators, Affiliations
Practice Guideline

AUA guideline for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome

Philip M Hanno et al. J Urol. 2011 Jun.

Abstract

Purpose: To provide a clinical framework for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome.

Materials and methods: A systematic review of the literature using the MEDLINE® database (search dates 1/1/83-7/22/09) was conducted to identify peer reviewed publications relevant to the diagnosis and treatment of interstitial cystitis/bladder pain syndrome. Insufficient evidence-based data were retrieved regarding diagnosis and, therefore, this portion of the Guideline is based on Clinical Principles and Expert Opinion statements. The review yielded an evidence base of 86 treatment articles after application of inclusion/exclusion criteria. These publications were used to create the majority of the treatment portion of the Guideline. When sufficient evidence existed, the body of evidence for a particular treatment was assigned a strength rating of A (high), B (moderate) or C (low). Additional treatment information is provided as Clinical Principles and Expert Opinion when insufficient evidence existed. See text and algorithm for definitions, and detailed diagnostic management, and treatment frameworks.

Results: The evidence-based guideline statements are provided for diagnosis and overall management of interstitial cystitis/bladder pain syndrome as well as for various treatments. The panel identified first through sixth line treatments as well as developed guideline statements on treatments that should not be offered.

Conclusions: Interstitial cystitis/bladder pain syndrome is best identified and managed through use of a logical algorithm such as is presented in this Guideline. In the algorithm the panel identifies an overall management strategy for the interstitial cystitis/bladder pain syndrome patient. Diagnosis and treatment methodologies can be expected to change as the evidence base grows in the future.

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Conflict of interest statement

CONFLICT OF INTEREST DISCLOSURES

All panel members completed conflict of interest disclosures. Those marked with (C) indicate that compensation was received; relationships designated by (U) indicate no compensation was received.

Consultant/Advisor: Philip M. Hanno, Astellas (C), Lilly(C), Watson(C), Taris (C), Trillium Therapeutics Inc.(C), Allergan(C), Pfizer(C); J. Quentin Clemens, Afferent Pharmaceuticals, Inc.(C), Lilly (C), Medtronic (C), United Biosource Corporation(C), Pfizer(C); Roger R. Dmochowski, Allergen(C), Antrares (C), Astellas (C), Medtronic (C), Merck(C), Pfizer (C), Johnson/Johnson (C), Serenity (C); Deborah R. Erickson, Trillium Therapeutics Inc.(C), NeurAxon (C); Mary P FitzGerald, Astellas (C), Robert Mayer, Lipella (C), Bioform(C), AbbyMoore Medical (C), Taris Biomedical (C), Pfizer (C), Allergan(C); Diane K. Newman, Astellas (C), Pfizer(C), SCA Personal Products(C), Verathon Medical (C), Watson Pharma (C), Hollister(C), GlaxoSmithKline (C); Christopher K. Payne, Afferent Pharma (C), Allergan (C), AMS(C), Astellas (C), Eli Lilly (C)

Investigator: J. Quentin Clemens, Pfizer (U); Roger R. Dmochowski, Allergan (C), Christopher K. Payne, Celgene (U), Coloplast (U), Medtronic (U)

Investor/Advisor: J. Quentin Clemens, Merck (U); Christopher K. Payne, Curant (C)

Lecturer/Consultant/Advisor: David A. Burks, Astellas Pharma (C), GlaxoSmithKline Pharma (C), Bayer Corporation(C)

Meeting Participant or Lecturer: David Allen Burks, Astellas Pharma, US(C), Bayer HealthCare Corporation (C), GlaxoSmithKline Pharma, US (C); Mary P FitzGerald, Ferring, Inc.; Mikel L. Gray, Pfizer (C); Diane K. Newman, Allergan (C), Astellas (C), GlaxoSmithKline Pharma (C), Watson Pharma (C), Pfizer(C)

Researcher/Scientific Study or Trial: Diane K. Newman, Allergan (C), GTX (C), Contura(C); Robert D. Mayer, M.D., Allergan (C), Pfizer (C)

Speaker Honorarium: Mary P FitzGerald, Astellas (C), Ferring, Inc (C)

Other: Roger R. Dmochowski, Contura (C)

References

    1. Hsu C and Sandford BA: The Delphi Technique: making sense of consensus. Practical Assessment, Research & Evaluation 2007; 12: 1.
    1. Higgins JDA: Assessing quality of included studies in Cochrane Reviews. The Cochrane Collaboration Methods Groups Newsletter 2007; 11.
    1. Faraday M, Hubbard H, Kosiak B et al.: Staying at the Cutting Edge: a review and analysis of evidence reporting and grading: the recommendations of the American Urological Association. British Journal of Urology—International 2009; 104: 294. - PubMed
    1. Hanno P and Dmochowski R: Status of international consensus on interstitial cystitis/bladder pain syndrome/painful bladder syndrome: 2008 snapshot. Neurourology and Urodynamics 2009; 28: 274. - PubMed
    1. Hanno PM, Landis JR, Matthews-Cook Y et al.: The diagnosis of interstitial cystitis revisited: lessons learned from the National Institutes of Health Interstitial Cystitis Database study. J Urol 1999; 161: 553. - PubMed

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