Alkalinized Lidocaine and Heparin Provide Immediate Relief of Pain and Urgency in Patients with Interstitial Cystitis

Abstract

Introduction It has been reported in an open-label study that the combination of alkalinized lidocaine and heparin can immediately relieve the symptoms of urinary urgency, frequency, and pain associated with interstitial cystitis (IC). This combination has also been reported to relieve pain associated with sex in patients with IC. Aim The aim of this study was to corroborate these findings in a multicenter setting. Methods The study design was a multicenter prospective, double-blind, crossover, placebo-controlled trial. Each participant met all of the clinical National Institute of Diabetes and Digestive and Kidney Diseases criteria (excluding cystoscopy) for IC. Each patient received drug and control, in random order, within 48 hours of enrolling in the study. Main Outcome Measures The primary outcome measure was percent change in pain score (11-point analog pain scale) 12 hours after receiving the drug or control. Secondary measures were the global assessment response (GAR) of symptoms and 12-hour average urgency reduction determined from 11-point urgency scales. Results Eighteen (18) patients completed the trial. The average reduction of pain over 12 hours was 21% for control and 42% for active drug (P = 0.0363). GAR was 13% for control and 50% for drug (P = 0.0137). Average urgency reduction was 13% for control and 35% for drug (P = 0.0328). Conclusions The combination of alkalinized lidocaine and heparin provides up to 12 hours of relief from urgency and pain associated with IC. This combination provides significant immediate relief of symptoms for patients with IC.

Intravesical treatment for interstitial cystitis/painful bladder syndrome: a network meta-analysis

“…1). After a full-text review, the reasons for excluding reports were non-RCTs [4,26], other intervention interference [27,28], other similar diseases [9,29,30], and lack of desired outcome assessment [31]. The general characteristics of the studies included are presented in Table 1.…”

A Systematic Review and Meta-analysis on the Efficacy of Intravesical Therapy for Bladder Pain Syndrome/Interstitial Cystitis

“…The majority of the selected publications referred to BPS/ IC therapy, except for 2 papers on ChS 0.2 %, which evaluated the product in patients with overactive bladder [25,26] and for the prophylaxis of radiation cystitis [27]; 2 of the excluded articles reported on the efficacy of a combination of heparin and lidocaine as an acute analgesic intervention for severe pain [28,29].…”

Intravesical Heparin: Interstitial Cystitis (Painful Bladder Syndrome)

“…Both pH and lidocaine stability should be determined after the components have been mixed prior to administration. 4 …”

“…4 Weekly bladder instillations with 4% lidocaine (5 mL)/heparin (20,000 units)/7% sodium bicarbonate (25 mL), instilled into an empty bladder via catheter and allowed to dwell for 30 minutes before drainage. 5 Twice-weekly intravesical instillations with heparin (25,000 units) for 3 months.…”