EP1099 Intravesical sodium hyaluronate for treatment of cystitis & bladder pain in women with pelvic malignancies

Introduction: Patients with a history of bladder pain syndrome/interstitial cystitis (BPS/IC) and who responded poorly or unsatisfactorily with previous treatment were compared taking intravesical hyaluronic acid (HA) or hyaluronic acid-chondroitin sulphate (HA-CS).Methods: Patients were treated with intravesical instillation with 50 mL sterile sodium hyalurinic acid (Hyacyst, Syner-Med, Surrey, UK) (n = 32) and sodium hyaluronate 1.6% sodium chondroitin sulphate 2% (Ialuril, Aspire Pharma, UK) (n = 33). Intravesical instillations were performed weekly in first month, every 15 days in the second month and monthly in third and fourth months, for a total of 8 doses. Patients were evaluated using a visual analog pain scale (VAS), interstitial cystitis symptom index (ICSI), interstitial cystitis problem index (ICPI), voiding diary for frequency/nocturia, cystometric bladder capacity and voided volume at the beginning and at 6 months. All patients had a potassium sensitivity test (PST) initially. Wilcoxon and Mann-Whitney U tests were used for statistical analysis.Results: In total, 53 patients met the study criteria. There were 30 patients in the HA-CS group (mean age: 48.47) and 23 patients in the HA group (mean age: 49.61) (p > 0.05). The initial PST was positive in 71.7% patients (38/53) overall with no difference between groups (p > 0.05). Responses for VAS, ICCS, ICPS, 24-hour frequency/nocturia statistically improved in both groups at 6 months. There was no significant difference in symptomatic improvement (p > 0.05). Eight patients had mild adverse events.Conclusion: HA and HA/CS instillation can be effective in BPS/IC patients who do not respond to conservative treatment. An important limitation of our study is that the HA dosage of the 2 treatment arms were different. It would be more appropriate with same HA dosage in both groups; however, there was no commercially available glycosaminoglycan (GAG) substance with same HA dosage for single and combination therapy. Large, long-term randomized studies are required to determine if there is a difference between these treatments.

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A comparative analysis of intravesical sodium hyaluronate monotherapy and its combination with oral chondroitin sulfate in patietns with bladder pain syndrome/intersticial cystitis

Urologiia ◽

10.18565/urology.2019.16.35-39 ◽

2019 ◽

Vol 1_2019 ◽

pp. 35-39

Author(s):

I.A. Aboyan Aboyan ◽

V.E. Aboyan Aboyan ◽

S.V. Pavlov Pavlov ◽

O.V. Zin’kovskaya Zin’kovskaya ◽

D.S. Pavlov Pavlov ◽

...

Keyword(s):

Comparative Analysis ◽

Chondroitin Sulfate ◽

Sodium Hyaluronate ◽

Pain Syndrome ◽

Bladder Pain Syndrome ◽

Bladder Pain

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Evaluation of radiation cystitis treatment efficacy with glycosaminoglycan replenishment therapy

Cancer Urology ◽

10.17650/1726-9776-2018-14-2-156-161 ◽

2018 ◽

Vol 14 (2) ◽

pp. 156-161

Author(s):

Ya. B. Mirkin ◽

A. M. Ponomarenko ◽

A. V. Karapetyan ◽

S. Yu. Shumoff

Keyword(s):

Treatment Efficacy ◽

Treatment Options ◽

Sodium Hyaluronate ◽

Intravesical Therapy ◽

Intravesical Administration ◽

Radiation Cystitis ◽

Chronic Radiation ◽

Pelvic Malignancies ◽

Bladder Instillation ◽

Oral Sodium

Background. Radiation cystitis is a severe late consequence of radiation therapy of pelvic malignancies. Destruction of glycosaminoglycan’s protective barrier (GAG-layer) plays key role in pathogenesis of radiation cystitis. Hence, GAG-replenishment therapy could be a promised method of treatment the radiation cystitis.The objective is to evaluate the effectiveness of glycosaminoglycan replacement therapy of chronic radiation cystitis using bladder instillation. Materials and methods. 23 female patients with radiation cystitis participated in the retrospective study. They have been randomized divided on two groups. Patients of the 1st group have been treated with intravesical administration of 0,08 % sodium hyaluronate alone, 2nd group – with intravesical sodium hyaluronate in combination with oral sodium hyaluronate and chondroitin sulfate.Results. Patients of both groups demonstrated less frequency and pain after treatment as well as increased bladder volume. Intravesical administration of glycosaminoglycans in combination with oral administration was more effective than intravesical therapy alone.Conclusions. GAG-replenishment therapy is a promised treatment options of radiation cystitis. Oral and intravesical GAG-replenishment therapy is more effective in comparison with only intravesical therapy.

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