Amitriptyline plus hydrodistension versus hydrodistension alone for treating interstitial cystitis bladder pain syndrome

Abstract

Purpose: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a debilitating condition that is difficult to diagnose and treat. The aim of this study was to investigate whether a combination treatment of amitriptyline after bladder hydrodistension is more beneficial for IC/BPS patient. Methods: Seventy-six patients’ dates diagnosed with IC/BPS were collected: the hydrodistension group (34 patients) and the combination group (42 patients), which received amitriptyline (25 mg ~ 50 mg/d) for 3 months following hydrodistension. The efficacy was evaluated at the 3rd and 6th months by using index scores. In addition, adverse events of amitriptyline and hydrodistension were recorded. Results: There was no difference in two groups at baseline. The ICSI, ICPI, AIS, SAS, OABSS, VAS and FVC scores improve significantly in the combination group than in the hydrodistension group at 3 months after hydrodistension . After 3 months of amitriptyline withdrawal, obvious improvement in the combination group was observed only for the AIS at the 6th month. At the 6th month, the indexes of the two groups still improved significantly compared with those recorded prehydrodistension; however, there was no difference in the improvement of maximum bladder volume in both groups before and after hydrodistension (P > 0.05). The adverse events of amitriptyline all were in the tolerable range. Conclusions: Hydrodistension under general anesthesia effectively relieved IC patients’ symptoms for at least 6 months. The three-month usage of amitriptyline alleviated the symptoms and problems more quickly and safely after hydrodistension in patients with IC/BPS.