title: Intravesical hyaluronic acid and alkalinized lidocaine for the treatment of severe painful bladder syndrome/interstitial cystitis.
abstract: OBJECTIVE
  Intravesical instillation of hyaluronic acid (HA) may restore the integrity of glycosaminoglycan layer in patients with painful bladder syndrome/interstitial cystitis (PBS/IC), and the benefit may be improved with addition of alkalinized lidocaine (AL).
  
  
  METHODS
  48 women with severe PBS/IC who failed oral medications were enrolled and divided into one trial and two control groups. The trial group received intravesical 40 mg HA, 10 ml of 2 % lidocaine and 5 ml of 8.4 % sodium bicarbonate on a weekly basis for 8 weeks and then monthly for 4 months with a subsequent follow-up of 24 weeks, while the two control groups received 40 mg HA and mixture of 10 ml of 2 % lidocaine and 5 ml of 8.4%sodium bicarbonate respectively following the same procedure. Response to therapy was evaluated by Global Response Assessment, voids per day, Visual Analogue Scale for pain, frequency and urgency, O'leary-Sant Interstitial Cystitis Symptom Index and Problem Index, cystoscopy and bladder capacity.
  
  
  RESULTS
  Overall 45 patients finished this study protocol. The HA + AL group and the AL group showed significant improvement at week 2 (P < 0.01), while the HA group began to show effect at week 4 (P < 0.01). There was no improvement in the AL group at week 24 and these patients quitted the study without follow up. Contrarily, the HA + AL and HA group kept on improving till the end of the study without significant difference between the two groups.
  
  
  CONCLUSIONS
  Intravesical instillation of HA and AL may provide both immediate and sustained relief of symptoms in severe PBS/IC in this preliminary study.
authors.affiliation: Department of Urology, First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, Fujian, People's Republic of China 350005. yisonglv@yahoo.com
authors.forename: Yi-Song
authors.initials: YS
authors.lastname: Lv
authors.forename: Hui-Liang
authors.initials: HL
authors.lastname: Zhou
authors.forename: Hou-Ping
authors.initials: HP
authors.lastname: Mao
authors.forename: Rui
authors.initials: R
authors.lastname: Gao
authors.forename: Yan-Dong
authors.initials: YD
authors.lastname: Wang
authors.forename: Xue-Yi
authors.initials: XY
authors.lastname: Xue
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage*; D018856:Cystitis, Interstitial / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D008012:Lidocaine / Q000008:administration & dosage*; D008875:Middle Aged; D010147:Pain Measurement; D055815:Young Adult
chemical_list: D000276:Adjuvants, Immunologic; D000779:Anesthetics, Local; D006820:Hyaluronic Acid; D008012:Lidocaine