Intravesical indwelling lidocaine‑releasing devices for IC/BPS (Review)

Abstract

Since the time the first case of interstitial cystitis/bladder pain syndrome (IC/BPS) was reported, there have been complaints of a decreased quality of life secondary to bladder pain; thus, effective treatment(s) are required. Several treatments have been developed, among which the intravesical instillation of lidocaine is considered one of the most favorable treatments due to the rapid local anesthetic action with minimal systemic side-effects, and even serves as a potential diagnostic tool for IC/BPS. In addition, the anti-inflammatory effects of lidocaine are associated with a longer duration of pain relief as compared to the effects of local anesthetic by breaking the vicious cycle of neurogenic inflammation. However, the main difficulty encountered with this treatment is the low absorption rate and the lack of maintaining a monthly effect. To overcome this difficulty, several approaches, including alkalization or the use of drug cocktails have been attempted. Recently, several indwelling lidocaine-releasing devices have been developed; however, the majority of these devices have not yet entered clinical trials, at least to the best of our knowledge. The only device evaluated in phase II clinical trials to date has failed to demonstrate a statistically significant efficacy compared to the placebo group. If the efficacy is improved and further clinical evidence is collected, the use of IC/BPS as a treatment strategy may become feasible. Contents 1. Introduction 2. Literature selection 3. Overview of IC/BPS 4. Pharmacological effects of lidocaine 5. Diagnostic significance of lidocaine in IC/BPS 6. Therapeutic significance of lidocaine in IC/BPS 7. Intravesical indwelling lidocaine-releasing devices 8. Conclusions and future perspectives

Circadian Rhythms Fluctuate the Treatment Effects of Intravesical Treatments on Rat Urinary Frequency Models

“…Te intravesical instillation of several drugs/chemicals such as lidocaine, capsaicin, resiniferatoxin, silver nitrate (AgNO 3 ), and dimethyl sulfoxide (DMSO) has already demonstrated some efcacy in treating overactive bladder, interstitial cystitis, bladder pain syndrome, and hemorrhagic cystitis [5][6][7][8][9]. However, the reported treatment efect of these drugs to date is less remarkable than expected, and a more efective technique for intravesical instillation of drugs, such as bladder indwelling devices, is needed [10].…”