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

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.