Interstitial Cystitis (IC)

What Does the Evidence Say?

The first line of treatment is  education, behavioral modifications, and stress management. 

The second line of treatment is pelvic floor physical therapy with an evidence grade of "A". (Pelvic floor physical therapists also provide the first line of treatment.)

Oral medications such as amitriptyline with an evidence grade of "B". 

Bladder instillations with lidocaine (evidence grade "B"), heparin or DMSO (evidence grade of "C"). 

Third line of treatment would be to have a cystoscopy. 

The fourth line of treatment is having intra-bladder Botox and/or trial of neurostimulation. 

The fifth line of treatment is to trial cyclosporine A as an oral medication. 

The sixth line of treatment is to have a major surgery. 

So what does this mean? Pelvic floor physical therapy should always be considered the first line of treatment with an interstitial cystitis diagnosis.