Intravesical hyaluronic acid and alkalinized lidocaine for the treatment of severe painful bladder syndrome/interstitial cystitis.
Summary of "Intravesical hyaluronic acid and alkalinized lidocaine for the treatment of severe painful bladder syndrome/interstitial cystitis."
INTRODUCTION AND
HYPOTHESIS:
Intravesical instillation of hyaluronic acid (HA) may restore the integrity of glycosaminoglycan layer in patients with painful bladder syndrome/interstitial cystitis (PBS/IC), and the benefit may be improved with addition of alkalinized lidocaine (AL).
METHODS:
48 women with severe PBS/IC who failed oral medications were enrolled and divided into one trial and two control groups. The trial group received intravesical 40 mg HA, 10 ml of 2 % lidocaine and 5 ml of 8.4 % sodium bicarbonate on a weekly basis for 8 weeks and then monthly for 4 months with a subsequent follow-up of 24 weeks, while the two control groups received 40 mg HA and mixture of 10 ml of 2 % lidocaine and 5 ml of 8.4%sodium bicarbonate respectively following the same procedure. Response to therapy was evaluated by Global Response Assessment, voids per day, Visual Analogue Scale for pain, frequency and urgency, O'leary-Sant Interstitial Cystitis Symptom Index and Problem Index, cystoscopy and bladder capacity.
RESULTS:
Overall 45 patients finished this study protocol. The HA + AL group and the AL group showed significant improvement at week 2 (P < 0.01), while the HA group began to show effect at week 4 (P < 0.01). There was no improvement in the AL group at week 24 and these patients quitted the study without follow up. Contrarily, the HA + AL and HA group kept on improving till the end of the study without significant difference between the two groups.
CONCLUSIONS:
Intravesical instillation of HA and AL may provide both immediate and sustained relief of symptoms in severe PBS/IC in this preliminary study.
Affiliation
From the Department of Urology, the First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, Fujian, People's Republic of China, 350005, yisonglv@yahoo.com.
Journal Details
This article was published in the following journal.
Name: International urogynecology journal
ISSN: 1433-3023
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22576327
- DOI: http://dx.doi.org/10.1007/s00192-012-1802-3
Medical and Biotech [MESH] Definitions
Viscosupplementation
A therapeutic treatment typically involving INTRA-ARTICULAR INJECTIONS of HYALURONIC ACID and related compounds. The procedure is commonly used in the treatment of OSTEOARTHRITIS with the therapeutic goal to restore the viscoelasticity of SYNOVIAL FLUID, decrease pain, improve mobility and restore the natural protective functions of hyaluronan in the joint.
Hyalectins
A group of high molecular weight chondroitin sulfate proteoglycans that form aggregates with HYALURONIC ACID.
Clofibrate
A fibric acid derivative used in the treatment of HYPERLIPOPROTEINEMIA TYPE III and severe HYPERTRIGLYCERIDEMIA. (From Martindale, The Extra Pharmacopoeia, 30th ed, p986)
Hydrofluoric Acid
Hydrofluoric acid. A solution of hydrogen fluoride in water. It is a colorless fuming liquid which can cause painful burns.
Mucinoses
Mucoid states characterized by the elevated deposition and accumulation of mucin (mucopolysaccharides) in dermal tissue. The fibroblasts are responsible for the production of acid mucopolysaccharides (GLYCOSAMINOGLYCANS) in the ground substance of the connective tissue system. When fibroblasts produce abnormally large quantities of mucopolysaccharides as hyaluronic acid, chondroitin sulfate, or heparin, they accumulate in large amounts in the dermis.
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