Sherif Hammouda, Sebay Ahmed, Kandeel Wael, Othman Tarek, Fathi Abdallah, Mohey Ahmed, Eshazly Ali
Department of Urology, Benha University, Benha, Egypt.
Turk J Urol. 2018 Nov 21;45(4):296-301. doi: 10.5152/tud.2018.63600. Print 2019 Jul.
To evaluate the safety and efficacy of intravesical instillation of hyaluronic acid/chondroitin sulfate in the treatment of refractory painful bladder syndrome.
Forty patients were subjected to intravesical instillations of hyaluronic acid/chondroitin sulfate weekly for 4 weeks and at 6., 8., 12. and 16. weeks, afterwards. Then we evaluated the efficacy of this treatment modality by determining the mean changes in visual analogue scale (VAS) pain score, the pelvic pain and urgency/frequency questionnaire, the O'Leary-Sant interstitial cystitis symptoms index/problems index and 3 day-voiding diary results including daily number of voids and mean voided volume at 2 weeks, 3, and 9 months after the last dose (4 month) and urodynamic studies including cystometric capacity, 1 sensation of urination, and Q-max at 9 months after the last dose.
Thirty-seven patients (6 males 16.2%, 31 females 83.8%) completed the entire follow-up protocol of this study. Age of the patients ranged from 22 to 37 years (mean, 30.7±4.18 years) and their body mass indexes (BMIs) ranged between 29 and 37 kg/m (mean, 33.5±2.58 kg/m). An initial response to treatment in all parameters at variable degrees was noticed at 2 weeks after the last instillation when compared to the baseline, and these changes were statistically significant (p<0.001). Progressive improvement in all test parameters was noticed at 3 months after treatment, and this improvement was statistically significant compared with baseline and 2 weeks after treatment, respectively (p<0.001).
Intravesical instillation with both hyaluronic acid/chondroitin sulfate in the treatment of refractory painful bladder syndrome is safe, effective and well tolerated by all patients with no recorded side effects.
评估膀胱内灌注透明质酸/硫酸软骨素治疗难治性疼痛性膀胱综合征的安全性和有效性。
40例患者每周接受膀胱内灌注透明质酸/硫酸软骨素，共4周，之后在第6、8、12和16周进行灌注。然后，我们通过测定视觉模拟量表（VAS）疼痛评分、盆腔疼痛与尿急/尿频问卷、奥利里-桑特间质性膀胱炎症状指数/问题指数的平均变化，以及末次给药后2周、3个月和9个月的3天排尿日记结果（包括每日排尿次数和平均排尿量），评估这种治疗方式的疗效；还通过测定末次给药后9个月的膀胱测压容量、排尿感觉和最大尿流率进行尿动力学研究。
37例患者（6例男性，占16.2%；31例女性，占83.8%）完成了本研究的整个随访方案。患者年龄在22至37岁之间（平均30.7±4.18岁），体重指数（BMI）在29至37kg/m之间（平均33.5±2.58kg/m）。与基线相比，末次灌注后2周时，所有参数均出现了不同程度的初始治疗反应，且这些变化具有统计学意义（p<0.001）。治疗后3个月时，所有测试参数均有逐步改善，与基线和治疗后2周相比，这种改善具有统计学意义（p<0.001）。
膀胱内灌注透明质酸/硫酸软骨素治疗难治性疼痛性膀胱综合征是安全有效的，所有患者耐受性良好，未记录到副作用。
