What are the Canadian Urological Association (CUA) second-line treatment recommendations for interstitial cystitis/bladder pain syndrome (IC/BPS)?

Updated: Dec 04, 2020
  • Author: Eric S Rovner, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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CUA guidelines recommend pelvic floor physiotherapy for patients with pelvic floor muscle dysfunction (PFD). Massage, acupuncture, and trigger point injections are optional for patients with pelvic floor tenderness. 

The CUA recommends amitriptyline, cimetidine, hydroxyzine, or PSS as options after conservative therapies have failed, but notes that there is conflicting evidence of the effectiveness of PPS and expected benefits may be marginal in the majority of patients. In addition, CUA recommends gabapentin and quercetin, although evidence is weak. [4]

The CUA guidelines concur with the recommendations for DMSO, heparin and lidocaine. [4]

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