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Bladder Pain Syndrome

Syndrome de la vessie douloureuse : évaluation de l'acupuncture

1. Systematic Reviews and Meta-Analysis

1.1. Verghese 2016 Ø

Verghese TS, Riordain RN, Champaneria R, Latthe PM. Complementary therapies for bladder pain syndrome: a systematic review. Int Urogynecol j. 2016. 27(8):1127-36. [185254].

Introduction and hypothesis Bladder pain syndrome is a difficult condition to treat. The purpose of this systematic review is to assess the effectiveness of various complementary therapies available for treatment.
Methods This review was conducted in adherence with Preferred Reporting Items for Systematic Reviews. Citations were retrieved using a comprehensive database search (from inception to July 2014: CINAHL, Cochrane, EMBASE, Medline and SIGEL and grey literature). Studies that fulfilled the inclusion criteria were selected. Eligibility consisted of women with bladder pain syndrome, an intervention of alternative/complementary therapies and an outcome of improvement of symptoms. Information regarding study characteristics and primary outcomes was collated. The Cochrane risk of bias scale was used to evaluate the quality of the studies included.
Results A total of 1,454 citations were identified, 11 studies fulfilled the inclusion criteria (4 randomised control trials [RCTs] and 7 prospective studies). The key interventions studied were acupuncture, relaxation therapy, physical therapy, hydrogen-rich therapy, diet and nitric oxide synthetase.
Conclusion Therapies with the potential for benefit in patients with bladder pain syndrome are dietary management, acupuncture and physical therapy. These findings were obtained from small studies and hence caution is advised. Robustly designed multicentre RCTs on these complementary therapies are needed to guide patients and clinicians.
Acupuncture Aucun ECR en acupuncture inclus.

2. Clinical Practice Guidelines

⊕ positive recommendation (regardless of the level of evidence reported)
Ø negative recommendation (or lack of evidence)

2.1. Canadian Urological Association (CUA, Canada) 2016 ⊕

Cox A, Golda N, Nadeau G, Curtis Nickel J, Carr L, Corcos J, Teichman J. CUA guideline: Diagnosis and treatment of interstitial cystitis/bladder pain syndrome. Can Urol Assoc J. 2016;10(5):E136-E155. [192988].

Acupuncture (option in motivated patients, Grade B);
Guideline: Based on Level 1 evidence, pelvic floor physiotherapy can be recommended for patients identified with PFD, while some weak Level 2 evidence suggests that massage techniques, acupuncture, and trigger point injections are options for IC/BPS patients with pelvic floor tenderness.

2.2. Japanese Urological Association (JUA, Japan) 2009 ⊕

Homma Y, Ueda T, Ito T, Takei M, Tomoe H. Japanese guideline for diagnosis and treatment of interstitial cystitis. Int J Urol. 2009;16(1):4-16. [180927].

Grade of recommendation: c, Level of evidence for efficacy: D. Acupuncture is a traditional and relatively noninvasive therapy, although its precise mechanism of action is unclear. The efficacy of acupuncture for IC would be limited and transient, and repeated treatment will be required to maintain the effect. (‡V) A large placebo effect is reported. (‡V) It is an outpatient treatment with minimal morbidity.