Purpose. The following review focuses on the recent advancements in intravesical drug delivery, which brings added benefit to the therapy of detrusor overactivity and interstitial cystitis/painful bladder syndrome (IC/PBS). Results. Intravesical route is a preferred route of administration for restricting the action of extremely potent drugs like DMSO for patients of interstitial cystitis/painful bladder syndrome (IC/PBS) and botulinum toxin for detrusor overactivity. Patients who are either refractory to oral treatment or need to mitigate the adverse effects encountered with conventional routes of administration also chose this route. Its usefulness in some cases can be limited by vehicle (carrier) toxicity or short duration of action. Efforts have been underway to overcome these limitations by developing liposome platform for intravesical delivery of biotechnological products including antisense oligonucleotides. Conclusions. Adoption of forward-thinking approaches can achieve advancements in drug delivery systems targeted to future improvement in pharmacotherapy of bladder diseases. Latest developments in the field of nanotechnology can bring this mode of therapy from second line of treatment for refractory cases to the forefront of disease management. 1. Introduction Intravesical therapies have demonstrated varying degrees of efficacy and safety in treatment of interstitial cystitis/painful bladder syndrome (IC/PBS) [1] and overactive bladder OAB [2]. Pharmacotherapy by this route provides high local drug concentrations in the bladder with low risk of systemic side effects [3]. Conventional therapies for OAB and detrusor overactivity (DO), either neurogenic or idiopathic, have limited efficacy and acceptability. Anticholinergic medications, which are currently the mainstay of the treatment of OAB, are not always effective and often have undesirable side effects such as dry mouth and constipation [4]. Therefore, search for alternative therapies directed against local targets with fewer side effects is encouraged. The IC/PBS syndrome is characterized by pelvic pain and urinary storage symptoms (e.g., urinary urgency and frequency). The O’Leary-Sant symptom and problem score (interstitial cystitis symptom index (ICSI) and problem index (ICPI)) is recognized as one of the most reliable and valid instruments to identify the extent of bothersome symptoms and the most prominent voiding and painful symptoms in IC/PBS patients [5, 6]. Pentosan polysulfate, PPS, is a synthetic sulphated polysaccharide and is the only approved oral drug for IC/PBS, but it
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