Efficacy of intravesical capsaicin in chronic pelvic pain syndrome and painful bladder syndrome
Keywords:
Chronic pelvic pain syndrome, Painful bladder syndrome, Pain score, CapsaicinAbstract
Purpose: To study efficacy of intravesical capsaicin in chronic pelvic pain syndrome and painful bladder syndrome.
Materials and Methods: This study was prospective experimental study. All 19 patients in outpatient clinic were diagnosed chronic pelvic pain syndrome or painful bladder syndrome. We recorded from July 2007 to January 2009 at Siriraj Hospital. These patients were performed intravesical capsaicin instillation with 1 mM/L in 30% ethanol in normal saline 100 cc under spinal block or local intravesical 2% Xylocaine instillation. Pain score, daytime urination, nighttime urination were recorded before and after procedure 2 weeks, 1, 2 and 3 months.
Results: In 19 patients, there were 12 female (68.2 %) and 7 male (36.8 %) mean age was 47 years. Average duration of disease was 3.5 years. Average pain score (median+SD) was 7.5+1.7 (median+SD) and Daytime urination was 10+3.8 times and Nighttime urination was 4.5+2.9 times. A significant decrease in pain score was found from 7.5+1.7 pretreatment to 5+2.3, 2.5+2.4, 3+2.9, 3+2.6 at 2 weeks 1, 2 and 3 months after treatment (p-value<0.01). The frequency of urination was significant decrease both daytime and nighttime urination except first 2 weeks after intravesical capsaicin instillation because there was irritative symptoms from side effect of capsaicin.
Conclusions: Intravesical capsaicin instillation was provided good results and safe for chronic pelvic pain syndrome and painful bladder syndrome. There was significant decrease pain score and frequency of urination. But side effect of capsaicin was found in first 2 weeks due to irritative symptoms.
References
Alan J. Wein et al. 2007. Campbellûs urology. 9th. Philadelphia:Saunders Elsevier.
Lazzeri M, Beneforti P, Benaim G, Maggi CA, Lecci A, Turini D. Intravesical capsaicin for treatment of severe bladder pain: a randomized placebo controlled study. J Urol. 1996 Sep; 156(3): 947-52.
de Séze M, Wiart L, Ferriíre JM, de Séze MP, Joseph PA, Barat M. Intravesical instillations of capsaicin in urology: from pharmacological principles to therapeutic applications. Prog Urol. 1999 Sep; 9(4): 615-32.
Cruz F. Desensitization of bladder sensory fibers by intravesical capsaicin or capsaicin analogs. A new strategy for treatment of urge incontinence in patients with spinal detrusor hyperreflexia or bladder hypersensitivity disorders. Int Urogynecol J Pelvic Floor Dysfunct. 1998; 9(4): 214-20.
Manaboriboon N, Soontraps S, Tappayuthpijarn P. The long-term efficacy of Siriraj Capsaicin in idiopathic detrusor instability. Thai J Urol 2003; 24: 17-26.
Lazzeri M, Beneforti P, Spinelli M, Zanollo A, Barbagli G, Turini D. Intravesical resiniferatoxin for the treatment of hypersensitive disorder: a randomized placebo controlled study. J Urol. 2000 Sep; 164(3 Pt 1): 676-9
Ruksakul W, Soontrapa S, Leewansangtong S, Tappayuthpijarn P. The efficacy of capsaicin in overactive bladder. Siriraj Hosp Gaz 2000; 52(7): 484-491.
Srinualnad S, Amornvesukit T, Soontrapa S, Srinualnad S. Bladder perforation from Capsaicin infusion: A Case Report. Siriraj Hosp Gaz 2001; 53(1): 38-42.
Dasgupta P, Chandiramani V, Parkinson MC, Beckett A, Fowler CJ. Treating the human bladder with capsaicin: is it safe? Eur Urol 1998; 33(1): 28-31.
Silva C, Avelino A, Souto-Moura C, Cruz F. A light-and electron-microscopic histopathological study of human bladder mucosa after intravesical resiniferatoxin application. BJU Int 2001; 88(4): 355-60.
