No abstract

The objective of the study was to determine whether intravesical pentosanpolysulfate (PPS) reduces symptoms associated with bladder pain syndrome/interstitial cystitis (BPS/IC). In a prospective, uncontrolled, open-label study, 29 female patients with BPS/IC received 300 mg PPS intravesically twice a week for 10 weeks and thereafter a voluntary maintenance therapy once a month. Treatment response was assessed by Visual Analog Scale (VAS) for quality of life and O'Leary-Sant Symptom and Problem Index (OSPI). Patients were tested before treatment, after 5 weeks of treatment, and 1 week, 3, 6, and 12 months after termination of the initial treatment. Twenty-five patients underwent the 10-week treatment and the 3-month follow-up. Mean reduction of VAS/OSPI was from 8.8/26.4 before to 4/15.3 after treatment, 3.8/15.2 after 3 months, 3.8/14 after 6 months, and 3.4/12.1 after 12 months. In 21 patients, renewed instillation or maintenance therapy was necessary. Intravesical treatment with PPS reduces both the VAS and the OSPI in patients with BPS/IC.

These data demonstrate that in patients who respond symptomatically to intravesical GAG substitution therapy, cystometric bladder capacity is increased, whereas non-responders experience a decrease in bladder capacity.

Urinary interleukin-6 (IL-6) has been proposed as a sensitive and specific inflammatory marker in bladder pain syndrome/interstitial cystitis (BPS/IC). We therefore investigated the presence of urinary IL-6 in patients with BPS/IC to find a possible correlation with the symptoms before and after glycosaminoglycan substitution therapy. Urinary IL-6 levels of 25 BPS/IC patients were assessed semi-quantitavely (Milenia Quickline) before and after intra-vesical glycosaminoglycan substitution therapy. Patients received therapy twice weekly with 300 mg pentosanpolysulphate for 5 weeks. Responders were treated for another 5 weeks, whilst non-responders received 40 mg hyaluronic acid weekly for another 10 weeks instead. Treatment response was assessed by the visual analogue scale (VAS) for quality of life and O'Leary-Saint Symptom and Problem Index (OSPI) before, during the 5th week of the treatment and 1 week after the treatment. Before treatment, measurable IL-6 was found in urine samples from 9 out of 25 patients. After treatment, urinary IL-6 was detected in two patients only. The average VAS and OSPI scores before the treatment were 7.9 (4-10) and 25.4 (12-37), respectively. After the treatment, the average VAS and OSPI scores dropped to 5.5 (0-10) and 14.7 (1-29), respectively. No statistically significant difference was found between patients with and without urinary IL-6 and the VAS and OSPI scores before and after the treatment. The urinary IL-6 level in BPS/IC patients is neither suited as a diagnostic marker nor as a predictor of responses to therapies. For the future, it would be important to clarify whether there are subsets of patients with diseases of different aetiologies.

The aim of the study was to assess the longterm effects of acupuncture treatment in patients suffering from psychogenic erectile dysfunction (ED). Patients and Methods: Twenty patients with psychogenic ED who underwent acupuncture treatment between 1999 and 2001 were invited to an after-care interview with the items International Index of Erectile Function (IIEF) 15 Score, influence of acupuncture on quality of life, effect and duration of acupuncture treatment on erectile status and willingness to repeat the treatment. Results: Fifteen patients accepted our invitation. Comparison of the IIEF 15 Score shortly after treatment with the Score in 2005 showed no statistically relevant difference (P = 0.608). Sixty-seven percent (n = 10) of the after-care patients reported an improvement in their quality of life and 53% (n = 8) would repeat this acupuncture treatment. Conclusions: The results are a first indication that long-term effects could be reached through acupuncture treatment.