Intravesical bacillus Calmette-Guerin and dimethyl sulfoxide for treatmentof classic and nonulcer interstitial cystitis: A prospective, randomized double-blind study

Purpose: We conducted a prospective, double-blind study with a crossover de sign of intravesical bacillus Calmette-Guerin (BCG) and dimethyl sulfoxide to determine whether patients with classic and nonulcer interstitial cystit is, respectively, might benefit from either regimen. Materials and Methods: A total of 21 patients, including 11 with classic an d 10 with nonulcer interstitial cystitis, randomly underwent treatments wit h intravesical BCG or dimethyl sulfoxide and, if not improved, were treated with the other substance after a washout period. All 21 patients were eval uated with symptom questionnaires, including a visual analog pain scale and voiding diaries. Results: Regardless of regimen, there was no improvement; in maximal functi onal capacity. There was a reduction in urinary frequency following dimethy l sulfoxide treatment but only in the classic subtype (p <0.05), whereas no reduction was seen following BCG in either subtype. A substantial pain dec rease was noted in classic (p <0.05) as well as nonulcer (p <0.05) intersti tial cystitis following dimethyl sulfoxide. Conclusions: Intravesical BCG has been presented as a promising new option for treatment of interstitial cystitis. We failed to demonstrate benefit fr om this treatment. Dimethyl sulfoxide had no positive effect on maximal fun ctional capacity but resulted in a significant reduction in pain and urinar y frequency, although only in patients with classic interstitial cystitis.