New agents for the medical treatment of interstitial cystitis

Interstitial cystitis (IC) is a painful, sterile, disorder of the urinary b ladder characterised by urgency. frequency?, nocturia and pain. IC occurs p rimarily in women but also in men with recent findings indicating that chro nic, abacterial prostatitis may be a variant uf this condition. The prevale nce of IC has ranged from about 8 - 60 cases/100,000 female patients depend ing on the population evaluated. About 10% of patients have severe symptoms that are associated with Hunner's ulcers on bladder biopsy; the rest could be grouped in those with or without bladder inflammation. Symptoms of IC L ire exacerbated by stress, certain foods and ovulatory hormones. Man). pati ents also experience allergies, irritable bowel syndrome (IUS) and migraine s. There have been various reports indicating dysfunction of the bladder gl ycosaminoglycan (GAG) protective layer and man!: publications showing a hig h number of activated bladder mast cells. Increasing evidence suggests that neurogenic inflammation and/or neuropathic pain is a major component of IC pathophysiology. Approved treatments so far include intravesical administr ation of dimethylsulphoxide (DMSO) or oral pentosanpolysulphate (PPS). New treatments focus on the combined use of drugs tl-lat modulate bladder senso ry nerve stimulation (neurolytic agents). inhibit neurogenic activation of mast cells, or provide urothelial cytoprotection together R with new drugs with anti-inflammatory activity