title: The clinical effectiveness of intravesical sodium hyaluronate (cystistat®) in patients with interstitial cystitis/painful bladder syndrome and recurrent urinary tract infections.
abstract: OBJECTIVE
  Painful bladder syndrome/interstitial cystitis (PBS/IC) and recurrent urinary tract infections (UTI) are clinically challenging conditions to manage in patients. We evaluate the clinical use of intravesical sodium hyaluronate (Cystistat®) in both these patient groups who have completed treatment.
  
  
  METHODS
  Thirteen patients with recurrent UTIs (Group I) and 8 patients with PBS/IC (Group II) received intravesical sodium hyaluronate (Cystistat®). Preinstallation demographic parameters were statically comparable in both groups. The mean age of presentation was 54.6 years in Group I and 57.5 years in Group II (p = 0.9). All 13 patients in Group I were on low dose antibiotics. The mean number of installations completed in both groups was 9 (range 4-21).
  
  
  RESULTS
  Data was collected prospectively using a standard pre- and post-treatment questioner with the pelvic pain and urinary/frequency patient symptom scale. At a mean follow-up of 21 months a significant improvement in bladder pain (p = 0.05), daytime frequency (p = 0.03) and quality of life (p = 0.02) was noted in patients in Group I. Two patients had breakthrough UTIs during treatment. Within Group I, 7 (53%) patients responded well to treatment. Patients in Group II had a significant improvement in bladder pain (p = 0.02), urgency (p = 0.01), nocturia (p = 0.01) and quality of life (p = 0.04). Within Group II, 6 patients (75%) responded to treatment.
  
  
  CONCLUSIONS
  Intravesical sodium hyaluronate (Cystistat®) can be used with minimal side effects and good compliance in both groups of patients with PBS and recurrent UTIs. Longer follow-up and larger patient numbers in both groups will be required to confirm the long-term efficacy of these two clinically challenging groups of patients.
authors.affiliation: Department of Urology, Freeman Hospital, Newcastle upon Tyne, UK.
authors.forename: Ijabla
authors.initials: I
authors.lastname: Raymond
authors.affiliation: Department of Urology, Freeman Hospital, Newcastle upon Tyne, UK.
authors.forename: Nikhil
authors.initials: N
authors.lastname: Vasdev
authors.affiliation: Department of Urology, Freeman Hospital, Newcastle upon Tyne, UK.
authors.forename: Jill
authors.initials: J
authors.lastname: Ferguson
authors.affiliation: Department of Urology, Freeman Hospital, Newcastle upon Tyne, UK.
authors.forename: Marion
authors.initials: M
authors.lastname: Haskin
authors.affiliation: Department of Urology, Freeman Hospital, Newcastle upon Tyne, UK.
authors.forename: Liz
authors.initials: L
authors.lastname: Davis
authors.affiliation: Department of Urology, Freeman Hospital, Newcastle upon Tyne, UK.
authors.forename: Tahseen S
authors.initials: TS
authors.lastname: Hasan
keywords: Hyaluronic acid; Painful bladder syndrome; Recurrent urinary tract infection