International Urogynecology Journal

, Volume 19, Issue 5, pp 717–721

Hyaluronan treatment of interstitial cystitis/painful bladder syndrome

  • Claus R. Riedl
  • Paul F. Engelhardt
  • Kurosch L. Daha
  • Nike Morakis
  • Heinz Pflüger
Original Article

DOI: 10.1007/s00192-007-0515-5

Cite this article as:
Riedl, C.R., Engelhardt, P.F., Daha, K.L. et al. Int Urogynecol J (2008) 19: 717. doi:10.1007/s00192-007-0515-5

Abstract

The aim of this study is to evaluate the efficacy of intravesical hyaluronan therapy in interstitial cystitis/painful bladder syndrome (IC/PBS). One hundred twenty-six patients with IC/PBS and an average disease duration of 6.1 years were treated with weekly instillations of a 50-cm3 phosphate-buffered saline solution containing 40 mg sodium hyaluronate. To be eligible for hyaluronan treatment, a positive modified potassium test was requested as a sign of a urine–tissue barrier disorder. Data were obtained by a visual analogue scale (VAS) questionnaire rating from 0 to 10 that asked for global bladder symptoms before and after therapy. Additional questions evaluated the therapeutic impact on quality of life. A positive and durable impact of hyaluronan therapy on IC/PBS symptoms was observed—103 (85%) of the patients reported symptom improvement (≥2 VAS units). The mean initial VAS score of 8.5 decreased to 3.5 after therapy (p < 0.0001). Out of 121 patients, 67 (55%) remained with no or minimal bladder symptoms after therapy (VAS 0–2). The majority (101, 84%) reported significant improvement of their quality of life. Intravesical therapy had to be initiated again with good success in 43 patients (34.5%) as symptoms recurred after discontinuation of treatment, while the rest stayed free of symptoms for up to 5 years. In general, hyaluronan therapy was well tolerated and, with the exception of mild irritative symptoms, no adverse reactions were reported for a total of 1,521 instillations. Timely hyaluronan instillation therapy may lead to complete symptom remission or even cure in part of the IC/PBS patients, while some responders need continuous intravesical therapy. The present results suggest that selection of patients for hyaluronan therapy by potassium testing improves the outcome of intravesical therapy with a response rate of >80%.

Keywords

Interstitial cystitis Hyaluronan Instillation therapy GAG substitution Hyaluronic acid 

Copyright information

© International Urogynecology Journal 2007

Authors and Affiliations

  • Claus R. Riedl
    • 1
  • Paul F. Engelhardt
    • 1
  • Kurosch L. Daha
    • 2
  • Nike Morakis
    • 1
  • Heinz Pflüger
    • 2
  1. 1.Department of UrologyLandesklinikum ThermenregionBadenAustria
  2. 2.Department of Urology and Ludwig Boltzmann Institute for Andrology and UrologyViennaAustria

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