title: Instillation of Hyaluronic Acid via Electromotive Drug Administration Can Improve the Efficacy of Treatment in Patients With Interstitial Cystitis/Painful Bladder Syndrome: A Randomized Prospective Study.
abstract: OBJECTIVE
  In the treatment of interstitial cystitis, intravesical hyaluronic acid application may be suggested as a treatment option. In this randomized prospective study, the authors aimed to identify whether instilling the hyaluronic acid with electromotive drug administration (EMDA) would increase the tissue uptake and improve the efficacy.
  
  
  METHODS
  The data of 31 patients who had been diagnosed with bladder pain syndrome/interstitial cystitis (BPS/IC) between 2004 and 2005 were examined. The patients were randomized to two groups: patients in group A received hyaluronic acid directly with a catheter and patients in group B received hyaluronic acid with EMDA. The patients were followed for 24 months and the two groups were compared at certain time intervals. The primary end points of the study were visual analogue scale (VAS) score, global response assessment, and micturition frequency in 24 hours.
  
  
  RESULTS
  There were 6 males and 25 females. The two groups were similar in baseline parameters. The decrease in VAS score and the micturition frequency in 24 hours were significantly lower with EMDA at months 6 and 12. The difference between the two groups was not significant at months 1 and 24. Also, treatment with EMDA, positive KCl test, and pretreatment voiding frequency >17 were associated with higher response rates.
  
  
  CONCLUSIONS
  Hyaluronic acid installation is an effective glycosaminoglycan substitution therapy in patients with BPS/IC. Instillation of hyaluronic acid via EMDA can improve the efficacy of the treatment; however, lack of long-term efficacy is the major problem with this glycosaminoglycan substitution therapy.
authors.affiliation: Department of Urology, Ankara University Faculty of Medicine, Ankara, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Gülpınar
authors.affiliation: Department of Urology, Ufuk University School of Medicine, Ankara, Turkey.
authors.forename: Ahmet Hakan
authors.initials: AH
authors.lastname: Haliloğlu
authors.affiliation: Department of Urology, Ankara University Faculty of Medicine, Ankara, Turkey.
authors.forename: Mehmet İlker
authors.initials: Mİ
authors.lastname: Gökce
authors.affiliation: Department of Urology, Ankara University Faculty of Medicine, Ankara, Turkey.
authors.forename: Nihat
authors.initials: N
authors.lastname: Arıkan
keywords: Hyaluronic acid; Interstitial cystitis; Painful bladder syndrome