Results of Endovesical Hyaluronic Acid/Chondroitin Sulfate in the Treatment of Interstitial Cystitis/Painful Bladder Syndrome

D.      Porru; M.      Cervigni; L.      Nasta; F.      Natale; R.   Lo   Voi; C.      Tinelli; B.      Gardella; A.      Anghileri; A.      Spinillo; B.      Rovereto

Abstract

Objectives- The aim of our study was to test the effect of a more viscous compound than existent hyaluronic acid formulation in helping to restore a defective glycosaminoglycan layer, and therefore in improving Interstitial Cystitis/Painful Bladder Syndrome (IC/PBS) symptoms when administered intravesically in IC/PBS patients. Methods- A total of 23 female patients completed the study. Patients received endovesical administration of hyaluronic acid and chondroitin sulfate in normal saline, 40 ml, weekly for 12 weeks and then bi-weekly for 6 months, if there was initial response. Results- After 12 weeks treatment both Interstitial Cystitis Symptom and Problem Index (ICSI/ICPI), pelvic pain and Urgency/Frequency Symptom Scale (PUF) showed a mean significant improvement, which was maintained thereafter. The average number of voidings and mean voiding volumes revealed significant improvement after the 12 weeks treatment period, with a significant reduction and increase, respectively. Mean voiding volume increased from 143 ml to 191, which apparently was not reflected in a corresponding reduction of number of daily voids (from 15,5 to 14). VAS values decreased from 5,4 to 3,6 (pain) and from 6,0 to 3,5 (urgency) after the treatment cycle, showing a significant improvement. Conclusions- In our preliminary experience, the administration of intravesical hyaluronic acid plus chondroitine sulphate appears to be a safe and efficacious method of treatment in IC/PBS.

Keywords: Interstitial cystitis, Painful bladder syndrome, Hyaluronic acid, Chondroitine sulfate, Intravesical treatment

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