title: The use of intravesical hyaluronic acid for recurrent urinary tract infections in children: a case-series study.
abstract: BACKGROUND
  This is the first study performed to evaluate the effects of intravesical hyaluronic acid (IHA) instillation on diminishing the frequency of recurrent urinary tract infections (UTIs) in children.
  
  
  METHODS
  Fifteen children (10 girls, 5 boys) with recurrent UTIs were divided into two groups as either complicated (group 1) (with accompanying disorders including vesicoureteral reflux or neurogenic bladder) or uncomplicated patients (group 2). After administration of weekly four sessions of IHA therapy the patients were followed-up monthly for 2 years and classified as responsive (complete/partial) or unresponsive to treatment.
  
  
  RESULTS
  53.3% of the patients with recurrent UTIs were complicated. In group 1 (n = 8), complete and partial response rates were 62.5% (n = 5) and 25% (n = 2), respectively. There was no response in 12.5% (n = 1) of the cases in group 1. In group 2 (n = 7), complete and partial response rates were 71.4% (n = 5) and 14.3% (n = 1), respectively. In this group, 14.3% (n = 1) of the patients were found to be unresponsive to IHA treatment. No side effects were observed in any of the patients.
  
  
  CONCLUSIONS
  IHA administration is considered as an effective treatment modality which significantly reduces the prevalence of or even provides complete recovery from recurrent UTIs in childhood. Therefore, it is believed that this approach can be used as a promising alternative to widespread use of antibiotics in this patient group.
authors.affiliation: a Division of Pediatric Nephrology , Gazi University , Ankara , Turkey and.
authors.forename: Kibriya
authors.initials: K
authors.lastname: Fidan
authors.affiliation: a Division of Pediatric Nephrology , Gazi University , Ankara , Turkey and.
authors.forename: Bahar
authors.initials: B
authors.lastname: Büyükkaragöz
authors.affiliation: b Division of Pediatric Surgery , Gazi University , Ankara , Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Özen
authors.affiliation: b Division of Pediatric Surgery , Gazi University , Ankara , Turkey.
authors.forename: Billur
authors.initials: B
authors.lastname: Demirogullari
authors.affiliation: a Division of Pediatric Nephrology , Gazi University , Ankara , Turkey and.
authors.forename: Oguz
authors.initials: O
authors.lastname: Söylemezoglu
mesh_terms: D000283:Administration, Intravesical; D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D008297:Male; D011446:Prospective Studies; D012008:Recurrence; D012189:Retrospective Studies; D014552:Urinary Tract Infections / Q000188:drug therapy*
chemical_list: D006820:Hyaluronic Acid
keywords: Antibiotic prophylaxis; Hyaluronic acid; children; intravesical treatment; urinary tract infections