Sequential hydrodistension and intravesical instillation of hyaluronic acid under general anaesthesia for treatment of refractory interstitial cystitis: a pilot study
Pilot study looking at the combination of general anaesthetic hydrodistension and intravesical hyaluronic acid for treatment of refractory interstitial cystitis. Twenty-three treatment refractory patients were recruited with an average age 53.4 years. All underwent general anaesthetic cystoscopy, hydrodistension and instillation of hyaluronic acid (40 mg/50 ml). The bladder was then subsequently drained with the patient awake. Two initial treatments were carried out a month apart and duration between treatments increased depending upon symptom response. In the responders, the average number of treatments was 6.6 (median 4.5), duration between treatments was 3.1 months (median 2.6) and follow-up 15.8 months (median 16). Seventeen patients (74%) responded with immediate improvement in symptoms. In all responders, healing of ulceration and resolution of inflammation occurred. Average anaesthetic bladder capacity increased in the responder group from an average of 492 ml (median 500 ml) to an average of 776 ml (median 700 ml). Our pilot data suggests sequential hydrodistension and hyaluronic acid treatment under general anaesthesia may be considered for resistant cases of interstitial cystitis, especially those that cannot tolerate the instillation procedure under local anaesthesia. Further prospective trials are required.
KeywordsInterstital cystitis Hyaluronic acid Hydrodistension
- 2.Sant GR, Ucci A Jr, Alroy J (1986) Bladder surface glycosaminoglycans (GAGs) in interstitial cystitis. J Urol 135:175A, abstract 287Google Scholar
- 8.Sato H, Takahashi T, Ide H, Fukushima T, Tabata M, Sekine F, Kobayashi K, Negishi M, Niwa Y (1988) Antioxidant activity of synovial fluid, hyaluronic acid and two sub-components of hyaluronic acid. Synovial fluid scavenging effect is enhanced in rheumatoid arthritis patients. Arth Rheum 31:63CrossRefGoogle Scholar
- 9.Balasz EA, Denlinger JL (1984) The role of hyaluronic acid in arthritis and its therapeutic use. In: Peyron JG (eds) Osteoarthritis: current clinical and fundamental problems. Geigy, Basel pp 165, 174Google Scholar
- 13.Houpt JB, Aviad A (1990) Osteoarthritis of the knee: effect of intra-articular sodium hyaluronate. Clin Exp Rheumatol 4:80Google Scholar