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Use of the Pain Urgency Frequency (PUF) Questionnaire to Measure Response of Patients with Interstitial Cystitis/Painful Bladder Syndrome to a Treatment Regimen of Intravesical DMSO and 1% Lidocaine Solution

Shalom, Dara F. MD*; Klapper, Allan MD; Lin, Stephanie NSM; Gurshumov, Emil MD

Journal of Pelvic Medicine and Surgery: January-February 2009 - Volume 15 - Issue 1 - p 5-10
doi: 10.1097/SPV.0b013e318198692e
Original Articles

Objectives: To assess the response of patients with Interstitial Cystitis (IC)/Painful Bladder Syndrome (PBS) to a treatment regimen of intravesical DMSO and 1% lidocaine as measured by the Pelvic Pain and Urgency/Frequency (PUF) questionnaire.

Methods: All patients referred with a clinical history consistent with IC/PBS, tenderness on palpation of the bladder and PUF scores >12 were prospectively evaluated for their response to the treatment regimen. All patients completed the PUF questionnaire prior to initiation of treatment. Patients were treated with weekly intravesical infusions of 50 mL DMSO and 10 mL of 1% lidocaine for a total of 6 weeks. Patients were asked to complete the PUF questionnaire with each infusion as well as the week after the final infusion. Total, symptom, and bother scores following each weekly visit were compared with baseline.

Results: 41 patients completed the 6 week treatment course. By week two, there was a significant decrease in the mean total score (17.0 ± 4.9 versus 20.5 ± 3.8, P < 0.0001), symptom score (11.4 ± 3.3 versus 13.4 ± 2.3, P < 0.0004) and bother score (5.7 ± 2.2 versus 7.0 ± 1.9, P < 0.0001) compared with baseline. After 6 weeks of treatment, the mean scores remained significantly decreased.

Conclusions: Weekly infusions of a solution of DMSO and 1% lidocaine significantly improved total, symptom, and bother scores as assessed by the PUF questionnaire. A larger controlled trial is warranted to more fully evaluate the significance of this regimen.

Significant improvements in symptom, bother, and total scores on the PUF questionnaire were seen with weekly intravesical DMSO/1% lidocaine infusions.

From the *Department of Obstetrics and Gynecology, Weill Cornell Medical College of Cornell University, 525 East 68th St. Suite J-130, New York, New York, †Department of Obstetrics and Gynecology, New York Downtown Hospital, 170 William Street, New York, New York, and the ‡Weill Cornell Medical College of Cornell University, 1300 York Ave., New York, New York.

Corresponding Author: Allan Klapper, M.D., Chairman, Department of Obstetrics and Gynecology, New York Downtown Hospital, 170 William Street, New York, N.Y. 10038. Phone: 212–312–5880, Fax: 212–312–5878, Email:

© 2009 Lippincott Williams & Wilkins, Inc.