title: Treatment of Recurrent Bacterial Cystitis by Intravesical Instillations of Hyaluronic Acid.
abstract: OBJECTIVE
  To evaluate the results of intravesical instillations of hyaluronic acid (HA) in the treatment of recurrent bacterial cystitis (RBC), and to assess the rate of tolerability, the rate of recurrence of RBC and side effects of treatment.
  
  
  METHODS
  The study included 23 female patients from September 2012 to May 2013, aged 28-42 years. Twenty three women with a history of RBC, received intravesical instillations of HA once weekly for 6 weeks then once monthly for 8 months.
  
  
  RESULTS
  In 16 (69.6%) of patients, symptoms of RBC resolved after 8 months. In 5 (21.7%) patients after 8 months of HA treatment, urgency was reduced only by 30%. Therefore, it was decided to use combined therapy of HA and alpha blockers in this cohort group. There was a specific reduction (75%) in frequent urination at day and at night without urgency. Despite the use of above mentioned treatment, in 2 (8.7%) patients, RBC was still present and therefore the treatment was discontinued.
  
  
  CONCLUSIONS
  The use of HA protects mucosa of urinary bladder and alleviates symptoms of infection. The intra­vesical instillations of HA and combination of HA + alpha blockers seems to be an effective therapeutic alternative in patients with RBC.
authors.affiliation: Urological Outpatient Clinic, Warsaw, Poland. urodent@wp.pl.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Ząbkowski
authors.affiliation: Children's Hospital in Dziekanow Lesny, Warsaw, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Jurkiewicz
authors.affiliation: Military Institute of Medicine, Warsaw, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Saracyn
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage; D000283:Administration, Intravesical; D000328:Adult; D001424:Bacterial Infections / Q000188:drug therapy*; D003556:Cystitis / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007322:Instillation, Drug; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000276:Adjuvants, Immunologic; D006820:Hyaluronic Acid