The use of amitriptyline in patients with urinary frequency and pain

Objective. To evaluate the usefulness of amitriptyline (AMI) in the treatment of patients with urinary frequency or genital, pelvic, or suprapubic pain syndromes. Methods. Charts of 22 patients (12 male and 10 female) without interstitial cystitis and having vague nonspecific urinary and pelvic or genital complaints were reviewed. All were treated with AMI in doses ranging from 25 to 100 mg. Results. Eleven patients became symptom- free, six showed significant improvement and five did not respond. Four of the five could not tolerate the medication. Fifteen patients attempted tapering off the medication after 6 months, and 11 experienced an early return of symptoms. A therapeutic response was again seen with retreatment. Conclusions. AMI is therapeutically useful in vague voiding dysfunctions, especially in the presence of urinary frequency or genital, pelvic, or suprapubic pain. It is effective for the treatment of both men and women. The response is durable, but the dose of the medication must be maintained.