Department of Woman, Child and of General and Specialized Surgery, Second University of Studies of Naples, Largo Madonna delle Grazie n°1, 80138, Naples, Italy,
J Infect Chemother. 2013 Oct;19(5):920-5. doi: 10.1007/s10156-013-0609-6. Epub 2013 May 7.
Approximately 20-30% of women suffer from recurrent cystitis. Recently, the problem of bacterial internalization, especially by Escherichia coli, has been significantly emerging as the main cause of recurrent episodes. It is believed that such a process is favored by damage to the urothelial mucous membrane. Concerning this, intravesical therapy with hyaluronic acid alone or in association with chondroitin sulfate was shown to improve urothelium thickness and reduction of bacterial load in the urine. The aim of our study was to assess whether intravesical therapy with hyaluronic acid (HA) and chondroitin sulfate (CS) is more effective than antibiotic therapy in reducing episodes and symptoms of recurrent urinary tract infections. We compared the number of recurring episodes in three groups of patients affected by recurrent urinary tract infections assigned to three different therapeutic regimens: the first group was treated only with HA and CS, the second group with HA and CS associated with fosfomycin, and the third group was treated only with fosfomycin (F). We assessed the number of recurrent episodes for each patient that occurred during a 6- to 12-month follow-up. The results showed 72.7% of patients in the HA-CS group, 75% in the fosfomycin + HA-CS group, and only 30.4% in the fosfomycin group were event free at follow-up. The results were analyzed using the Fisher's exact test. In conclusion, intravesical therapy with hyaluronic acid and chondroitin sulfate is an effective therapeutic approach to treat and prevent episodes of recurrent cystitis.
大约 20-30%的女性患有复发性膀胱炎。最近，细菌内化问题，尤其是大肠杆菌，作为复发性发作的主要原因，已经明显出现。据认为，这种过程有利于尿路上皮粘膜的损伤。关于这一点，单独用透明质酸或与硫酸软骨素联合进行膀胱内治疗已被证明可改善尿路上皮厚度并减少尿液中的细菌负荷。我们的研究目的是评估透明质酸（HA）和硫酸软骨素（CS）的膀胱内治疗是否比抗生素治疗更能减少复发性尿路感染的发作和症状。我们比较了三组复发性尿路感染患者的复发次数，这些患者被分配到三种不同的治疗方案：第一组仅用 HA 和 CS 治疗，第二组用 HA 和 CS 联合磷霉素治疗，第三组仅用磷霉素（F）治疗。我们评估了每位患者在 6-12 个月随访期间发生的复发次数。结果显示，HA-CS 组有 72.7%的患者、磷霉素+HA-CS 组有 75%的患者、而仅用磷霉素组有 30.4%的患者在随访时无事件发生。结果采用 Fisher 确切检验进行分析。总之，透明质酸和硫酸软骨素的膀胱内治疗是治疗和预防复发性膀胱炎发作的有效治疗方法。
