Treatment of interstitial cystitis with Cystistat: a hyaluronic acid product.
OBJECTIVE
To determine whether intravesical hyaluronic acid id effective in reducing the urinary frequency and pain associated with interstitial cystitis/painful bladder syndrome (IC/PBS).


METHODS
In a prospective, unblinded, uncontrolled pilot study, 20 patients (age range 34-80 years), all suffering from IC/PBS, received weekly bladder instillations of hyaluronic acid for 1 month and monthly instillations for a further 2 months. Patients were then offered further monthly instillations and all were subsequently evaluated after 3 years. Patient outcomes assessed were urinary frequency, use of analgesics and pain.


RESULTS
All patients completed the 3 months of hyaluronic acid treatment with mean decreases in nocturia and pain of 40% and 30%, respectively, and decrease in analgesic use. Thirteen patients (65%) responded to treatment (responders) and continued therapy, while seven patents withdrew, six because of a lack of response and one due to cystectomy. In the 13 patients who continued hyaluronic acid instillations, four complete responders(30%) ceased therapy after a strong positive response (36%, 60% and 81% decreases compared to baseline in day-time voids, night-time voids and scores, respectively) which was maintained in the absence of continuous therapy, while after 3 years seven partial responders (35%) were still on therapy (25% and 43% decreases compared to baseline in day-time voids and pain scores, respectively). Two patients developed other diseases during follow-up and showed no response to long-term therapy. Hyaluronic acid was will tolerated by all patients.


CONCLUSIONS
Hyaluronic acid safely reduced the pain and, to lesser degree, the urinary frequency associated with IC.
Kallestrup
Else B
EB
Department of Urology, Herlev Hospital, Herlev, Denmark.
Jorgensen
Steinunn S
SS
Nordling
Jorgen
J
Hald
Tage
T
D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000627:therapeutic use*; D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018856:Cystitis, Interstitial / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D007322:Instillation, Drug; D008407:Mast Cells / Q000473:pathology; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D010147:Pain Measurement; D010865:Pilot Projects; D011446:Prospective Studies; D016896:Treatment Outcome; D014555:Urination Disorders / Q000188:drug therapy / Q000209:etiology
D000276:Adjuvants, Immunologic; D006820:Hyaluronic Acid