First-ever guidelines for the diagnosis and treatment of IC
SAN FRANCISCO, CA (UroToday.com) - May 29, 2010 - The 2010 American Urological Association’s annual meeting is underway and already the AUA’s IC guidelines committee is announcing, for the first time ever, guidelines for diagnosis and treatment of Interstitial Cystitis. Phil Hanno, MD, MPH is the co-chair of the ICA’s Medical Advisory Board as well as a representative of the AUA’s IC guidelines committee. The guidelines will be of most benefit for the IC patients who see doctors who don’t specialize in IC treatment and may not be aware of the medical literature that supports certain tests and treatments. Notably, the new guidelines don’t support using the potassium sensitivity test as a valid one for IC, nor do they support cystoscopy with hydrodistention under anesthesia for “uncomplicated” cases and don’t have many accompanying conditions, such as vulvodynia.
Some recommendations are:
- an IC-friendly diet
- physical therapy aimed at pelvic floor dysfunction
- stress management
[Webslave's comment: This sounds a lot like the Wise-Anderson Protocol + my recommendations to investigate diet!]
First-line treatments include the oral medicines amitriptyline, histamine blockers such as hydroxyzine (Atarax, Vistaril) or cimetidine (Tagamet), pentosan polysulfate (Elmiron) and bladder instillation therapy. Treatment recommendations then step up through five levels, most importantly no matter what level, the guidelines emphasize the importance of pain management.
Dr. Hanno emphasized that these guidelines are a work in progress and far from the final word on IC diagnosis and treatment. They do not include positive treatments that IC experts are just starting to use, but rather the guidelines reflect what’s been published so far in controlled trials or other trustworthy studies and on occasion expert opinion.
