Objective: To evaluate the safety and efficacy of intravesical instillation with both hyaluronic acid chondroitin sulfate in refractory painful bladder syndrome.
Material and Methods: Forty patients were subjected to intravesical instillation of hyaluronic acid chondroitin sulfate weekly for 4 weeks and at 6,8,12&16 weeks. Then we evaluated the efficacy by determining the mean changes in visual analogue scale pain score, the pelvic pain and urgency/frequency questionnaire the O’Leary-Sant interstitial cystitis symptoms index/ problems index and 3 days voiding diary including daily number of voids and mean voided volume at 2 weeks after last dose (4th month) and at 3 months and at 9 months after the last dose and urodynamic studies including cystometric capacity, 1st sensation and Q-max at 9 months after the last dose.
Results: Thirty seven patient (6 males 16.2% , 31 females 83.8%) completed the entire follow up protocol enrolled in this study, their age ranged from 22 to 37 years with mean 30,7 4.18 years and BMI between 29 and 37 with mean 33.5 2.58.
An initial response to treatment at variable degrees in all parameters was noticed at 2 weeks after the last instillation when compared to the baseline, and these changes were statistically significant ( p value ˂ 0.001 ). Progressive improvement in all test parameters was noticed at 3 months after treatment, and this improvement was statistically significant compared with baseline and at 2 weeks after treatment respectively (P value < 0.001).
Conclusions: Intravesical instillation with both hyaluronic acid chondroitin sulfate in refractory painful bladder syndrome is safe, effective and well tolerated by all patients with no recorded side effects.