The Efficacy and Safety of Dimethyl Sulfoxide Into the Bladder for the Treatment of Interstitial Cystitis/Bladder Pain Syndrome: A Systematic Review and Meta-Analysis.

Abstract

Objective: To investigate the efficacy and safety of intravesical DMSO instillation for the treatment of interstitial cystitis/bladder pain syndrome.

Method: The following databases were searched for relevant studies: PubMed, EMBASE, MEDLINE, Cochrane Library, and Web of Science (updated August 10, 2024). All studies on intravesical DMSO met the inclusion criteria and were evaluated using various quality assessment methods based on the type of study. Data were then analyzed using Review Manager 5.4 (Cochrane Collaboration software). The primary outcomes and indicators included the Interstitial Cystitis Symptom Index, the Interstitial Cystitis Problem Index, and Pain Scores. The secondary outcomes were bladder diary metrics and Pelvic Pain and Urgency/Frequency Symptom Scale (PUF).

Results: This systematic review and meta-analysis included 5 randomized controlled trials and 9 single-arm or cohort studies, involving 554 patients. The combined statistics indicated an average pretreatment Interstitial Cystitis Symptom Index score was 14.27, an average Interstitial Cystitis Problem Index Score was 12.72, and an average Pain Score was 7.06. Compared to pretreatment values, the results indicated that the Interstitial Cystitis Symptom Index score decreased by 5.59 (95% CI: -6.68 to -4.50, p < 0.00001), the Interstitial Cystitis Problem Index score decreased by 5.14 (95% CI: -6.45 to -3.83, p < 0.00001), and the Pain Score decreased by 3.27 (95% CI: -3.95 to -2.60, p < 0.00001). Additionally, the overall incidence rate of adverse events in patients was 37.6%. Although 37% of cases had adverse events, the majority were considered mild and acceptable.

Conclusion: Evidence-based statistical analysis of the literature on intravesical DMSO treatment for interstitial cystitis/bladder pain syndrome indicates that this therapy is both effective and safe. Therefore, intravesical DMSO instillation can be considered a standard treatment method for interstitial cystitis/bladder pain syndrome.