title: Systematic Review and Meta-Analysis of Intravesical Hyaluronic Acid and Hyaluronic Acid/Chondroitin Sulfate Instillation for Interstitial Cystitis/Painful Bladder Syndrome.
abstract: OBJECTIVE
  To assess the efficacy of intravesical hyaluronic acid (HA) and HA/chondroitin sulfate (CS) instillation in patients with interstitial cystitis/painful bladder syndrome by systematic review and meta-analysis.
  
  
  METHODS
  A systematic literature search was performed using the keywords: 'interstitial cystitis' or 'painful bladder syndrome' or 'bladder pain syndrome' and 'hyaluronic acid', up to March 31, 2016. The primary outcome was visual analogue scale related pain symptom (VAS). Secondary outcomes were the O'Leary-Sant Interstitial Cystitis Symptom Index (ICSI) and Problem Index (ICPI), frequency, nocturia, bladder volume, and voided urine volume.
  
  
  RESULTS
  Ten articles involving 390 patients were retrieved and assessed in analysis. A significant improvement in mean VAS on fixed-effect and random-effect models (mean difference [MD] -3.654, 95% confidence interval [CI] -3.814 to -3.495, and MD -3.206, 95% CI -4.156 to -2.257, respectively) was found. Significant improvements were found in the ICSI (MD -3.223, 95% CI -4.132 to -2.315) and ICPI (MD -2.941, 95% CI -3.767 to -2.116). Similarly, the other outcomes were significantly improved.
  
  
  CONCLUSIONS
  Intravesical HA and HA/CS instillation improved pain symptom, quality of life, and other outcomes and could be included as therapeutic modality of interstitial cystitis/painful bladder syndrome.
authors.affiliation: Department of Pathology, Eulji University School of Medicine, Daejeon, Republic of Korea.
authors.forename: Jung-Soo
authors.initials: JS
authors.lastname: Pyo
authors.forename: Won Jin
authors.initials: WJ
authors.lastname: Cho
mesh_terms: D000283:Administration, Intravesical; D002809:Chondroitin Sulfates / Q000627:therapeutic use*; D018856:Cystitis, Interstitial / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D053158:Nocturia / Q000503:physiopathology / Q000517:prevention & control*; D009929:Organ Size / Q000187:drug effects; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement; D011788:Quality of Life; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000187:drug effects / Q000503:physiopathology
chemical_list: D006820:Hyaluronic Acid; D002809:Chondroitin Sulfates