title: Intravesical Glycosaminoglycan Replacement with Chondroitin Sulphate (Gepan(®) instill) in Patients with Chronic Radiotherapy- or Chemotherapy-Associated Cystitis.
abstract: OBJECTIVE
  Intravesical instillation of glycosaminoglycans is a promising option for the treatment of chronic cystitis, as it supports the regeneration of the damaged urothelial layer. We investigated the efficacy of short-term intravesical chondroitin sulphate treatment (six courses of instillation) in patients with chronic radiotherapy- or chemotherapy-associated cystitis.
  
  
  METHODS
  This prospective, observational study included patients with chronic radiotherapy- or chemotherapy-associated cystitis, who received six once-weekly intravesical instillations of 0.2% chondroitin sulphate 40 mL. Every week, patients recorded their symptoms and their benefits and tolerance of treatment, using a self-completed questionnaire.
  
  
  RESULTS
  The study included 16 patients (mean age 68.5 years; 50% male). During the study, a reduction in all evaluated parameters was observed. After one dose of chondroitin sulphate, symptom improvement was observed in 38% of patients, and after the second dose, an additional 31% of patients showed improvement. At week 6, 80% of patients had either improved or were symptom free, and significant improvements in urinary urgency (p = 0.0082), pollakisuria (p = 0.0022), urge frequency (p = 0.0033) and lower abdominal pain (p = 0.0449) were observed. Haematuria, present in 9 of the 16 patients at baseline, was completely resolved in all cases after 6 weeks. The majority of patients (93%) evaluated the tolerance of chondroitin sulphate as 'good' or 'very good'. No treatment-related adverse events were reported.
  
  
  CONCLUSIONS
  Intravesical administration of chondroitin sulphate was effective for the treatment of radiotherapy- or chemotherapy-associated cystitis. Even short-term treatment appears to be effective in reducing symptoms and improving the quality of life of patients.
authors.affiliation: Department of Urology, Universitätsklinik Leipzig AöR (Leipzig University Hospital), Liebigstraße 20, 04103, Leipzig, Germany.
authors.forename: Thilo
authors.initials: T
authors.lastname: Schwalenberg
authors.forename: Frank Peter
authors.initials: FP
authors.lastname: Berger
authors.forename: Lars Christian
authors.initials: LC
authors.lastname: Horn
authors.forename: Phuc Ho
authors.initials: PH
authors.lastname: Thi
authors.forename: Jens-Uwe
authors.initials: JU
authors.lastname: Stolzenburg
authors.forename: Jochen
authors.initials: J
authors.lastname: Neuhaus
mesh_terms: D000283:Administration, Intravesical; D000368:Aged; D002809:Chondroitin Sulfates / Q000008:administration & dosage* / Q000009:adverse effects; D002908:Chronic Disease; D003556:Cystitis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D002809:Chondroitin Sulfates