Korean J Urol.  2001 Jun;42(6):615-620.

The Clinical Effects of Amitriptyline in Patients with Urinary Frequency and Chronic Pelvic Pain Syndrome

• Lee DH
• Park CH
• Kim CI

Abstract

PURPOSE: We evaluated the effects of amitriptyline in patients with urinary frequency or pelvic pain syndrome and compared with propiverine hydrochloride (BUP-4(R)) and diazepam (Valium(R)).
MATERIALS AND METHODS
One-hundred and sixty-eight patients with urinary frequency or pain were included and 38 out of 168 patients were lost to follow up. The patients with interstitial cystitis, UTI and neurogenic bladder were excluded. Amitriptyline group were instructed to take 25mg to 75mg of amitriptyline before bed. Propiverine hy drochloride and diazepam group were instructed to take 20mg, 4-6mg before bed, respectively. The clinical effects and side effects were evaluated after 4 weeks of medication.
RESULTS
In the amitriptyline group, 73.1% in 78 patients with frequency, 68.3% in 60 pain, 65.6% in 32 nocturia, 53.8% in 26 weak urinary stream, 53.8% in 13 dysuria, 72.7% in 11 urgency showed symptom improvement. Urinary frequency and pain score were significantly decreased in the amitriptyline group. In the propiverine hydrochloride group, 66.7% in 21 patients with frequency, 38.8% in 18 pain showed symptom improvement. In the diazepam group, 37.5% in 24 patients with frequency, 31.3% in 16 pain showed symptom improvement. Side effects of amitriptyline had appeared in 24 (27.6%) out of 87 patients; 17 cases of dry mouth, 10 drowsiness, 2 agitation, 2 nausea, 1 constipation and 1 skin rash.
CONCLUSIONS
Amitriptyline is useful in vague voiding symptoms especially in urinary frequency and chronic pelvic pain syndrome. It is equally effective in both men and women. Side effects are minimal and tolerable. A double-blind placebo-controlled trial is necessary for general acceptance in the future.

Keyword

Urinary frequency; Pelvic pain syndrome; Amitriptyline; Propiverine hydrochloride; Diazepam

MeSH Terms

Amitriptyline*
Constipation
Cystitis, Interstitial
Diazepam
Dihydroergotamine
Dysuria
Exanthema
Female
Humans
Lost to Follow-Up
Male
Mouth
Nausea
Nocturia
Pelvic Pain*
Rivers
Sleep Stages
Urinary Bladder, Neurogenic
Amitriptyline
Diazepam
Dihydroergotamine