Sequential hydrodistension and intravesical instillation of hyaluronic acid under general anaesthesia for treatment of refractory interstitial cystitis: a pilot study

Ahmad, Imran; Krishna, Nalagatla Sarath; Meddings, R.N.

doi:10.1007/s00192-007-0443-4

Cited by 29 publications

(18 citation statements)

References 14 publications

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“…Leppilahti et al reported complete or partial response in eight patients out of 12 with this technique [22]. Ahmad et al recently reported their experience on 23 patients: they obtained a response rate of 74% with an average follow up of 15.8 months [24]. In a different study, HA was used in combination with CS, another component of the GAG layer, which was administered systemically with promising results in patients with refractory PBS/IC.…”

Section: Discussionmentioning

confidence: 99%

A combined intravesical therapy with hyaluronic acid and chondroitin for refractory painful bladder syndrome/interstitial cystitis

Cervigni

Natale

Nasta³

et al. 2008

Int Urogynecol J

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The aims of this study were to evaluate the efficacy and tolerability of intravesical instillations of high-molecular-weight hyaluronic acid (HA) 1.6% and chondroitin sulfate (CS) 2.0% in patients with refractory painful bladder syndrome/interstitial cystitis (PBS/IC) and to observe their impact on Quality of Life. Twenty-three women were enrolled. They received bladder instillations with HA and CS weekly for 20 weeks and then monthly for 3 months. Mean follow-up after completion of therapy was 5 months. We observed a significant improvement in urinary symptoms on voiding diaries and Visual Analogue Scale for frequency (p = 0.045), urgency (p = 0.005), and pain (p = 0.001). The O'Leary-Sant Interstitial Cystitis Symptom Index and Interstitial Cystitis Problem Index resulted in a significant improvement in both scores (p = 0.004 and 0.01, respectively). The Pelvic Pain and Urgency/Frequency Symptom Scale only showed significant improvement in the symptom score (p = 0.001). This promising experience seems to offer an additional therapeutic option in patients with refractory PBS/IC.

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Section: Discussionmentioning

confidence: 99%

A combined intravesical therapy with hyaluronic acid and chondroitin for refractory painful bladder syndrome/interstitial cystitis

Cervigni

Natale

Nasta³

et al. 2008

Int Urogynecol J

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“…Hydrodistension with and without instillation additives has been shown to be an effective therapeutic procedure for IC/BPS and is generally a safe procedure other than rare reports of bladder rupture. [162][163][164] However, relief of symptoms from hydrodistension therapy has been shown to decline over the time scale of months, with a wide variation in efficacy thought to be partly due to many different practices for hydrodistention. 19,80,165,166 Greater duration of therapy has been found in patients with ulcerative IC/PBS and in patients without comorbidities such as IBS.…”

Section: Treatmentmentioning

confidence: 99%

Interstitial Cystitis/Bladder Pain Syndrome

Marcu

Campian

2018

Semin Reprod Med

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Interstitial cystitis/bladder pain syndrome is an uncommon but potentially devastating pelvic pain disorder affecting both women and men. This condition is often confusable and comorbid with other pelvic pain disorders. Although our understanding of the underlying pathophysiology is growing, the exact longitudinal course by which peripheral and central aberrations involving the bladder mucosa, peripheral inflammation, and central dysregulation of bladder sensitivity create painful bladder symptoms remains an area in need of further study. Only a limited number of drugs have been approved for treatment by the Food and Drug Administration, and overall durable efficacy of the many treatments reviewed in recent American Urological Association guidelines remains suboptimal, making awareness, early diagnosis, and use of effective treatments early in the disease course, where neural changes may still be reversible, imperative.

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“…Ahmad and colleagues and Shao and colleagues used 40 mg HA administered intravesically to prolong the bladder capacity obtained after BH [Shao et al 2010;Ahmad et al 2008]. They observed in each study an improvement in mean bladder capacity; 492 ml versus 776 ml after 16 months of follow up in the 23 patients [Ahmad et al 2008]; þ27 ml versus À5 ml in the placebo group after 6 months [Shao et al 2010]. …”

Section: Pbs/icmentioning

confidence: 99%

The role of sodium hyaluronate and sodium chondroitin sulphate in the management of bladder disease

Damiano

Cicione

2011

Therapeutic Advances in Urology

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Bladder epithelium is not only a simple defence against infections, but it is also a specialized tissue regulating complex bladder functions and playing an active role in the pathogenesis of many bladder diseases. There is strong evidence that different chronic inflammatory bladder diseases, such as recurrent urinary tract infection (UTI), chemical or radiation cystitis and painful bladder syndrome/interstitial cystitis (PBS/IC), can be pathophysiologically linked in the first step of the disease to the loss of the glycosaminoglycan (GAG) mucous layer independently of the original cause of the inflammatory process. The aim of this article is to review the current evidence on the clinic applications of GAGs in urology, with particular emphasis on the therapeutic use of hyaluronic acid (HA) and chondroitin sulphate (CS). A comprehensive electronic literature search was conducted in May 2011 using the Medline database. Three studies supported the decrease of the rate of recurrent UTIs by restoring the GAG layer, showing a significant reduction of UTI rates and a prolonged median time to recurrence after HA intravesical instillations in women with recurrent UTI. We provide higher level evidence by reporting a prospective, randomized, double-blind, placebo-controlled study on the use of intravesical HA and CS in women with recurrent UTIs. A significant reduction of 77% in the UTI rate per patient per year versus placebo was observed at the end of the study. Nine studies were published between 2002 and 2011 on the use of HA and CS to treat PBS/IC. Three of them evaluated the use of GAGs bladder instillation to prolong the effects of bladder hydrodistension. In the other six studies the efficacy of HA bladder instillations to reduce symptoms score was assessed. Preliminary studies support data on the role of HACS in detrusor overactivity, nonbacterial cystitis and urological malignancies. Few data are available regarding the mode of action of HACS or its effectiveness in the management of bladder diseases. The major issue in interpreting the available evidence regarding HACS is that most of the reported studies are nonrandomized and without a control arm. HACS may be considered for further studies, including randomized, controlled trials with adequate power.

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Sequential hydrodistension and intravesical instillation of hyaluronic acid under general anaesthesia for treatment of refractory interstitial cystitis: a pilot study

Cited by 29 publications

References 14 publications

A combined intravesical therapy with hyaluronic acid and chondroitin for refractory painful bladder syndrome/interstitial cystitis

A combined intravesical therapy with hyaluronic acid and chondroitin for refractory painful bladder syndrome/interstitial cystitis

Interstitial Cystitis/Bladder Pain Syndrome

The role of sodium hyaluronate and sodium chondroitin sulphate in the management of bladder disease

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