Efficacy comparison of interstitial cystitis/painful bladder syndrome patients treated with four-drug combination and sodium hyaluronate intravesical instillation / 中华泌尿外科杂志

ABSTRACT

Objective To compare the outcomes between interstitial cystitis/painful bladder syndrome (IC/PBS) patients treated with four-drug combination (heparin,lidocaine,sodium bicarbonate,gentamicin) and sodium hyaluronate intravesical instillation.Methods There were 23 IC/PBS patients from Jan.1,2011 to Mar.1,2013.Ten patients (group A) received four-drug combination (heparin 40 000 U,'gentamicin 160 000 U,sodium bicarbonate 1％,lidocaine 0.4％) instillation treatment.Thirteen patients received instillation of sodium hyaluronate (40 mg/50 ml) therapy (group B).In group B,intravesical instillations were performed weekly in the first 6-8 weeks,and monthly until one year.Patients in group A received intravesical instillation twice a week in the first 6-8 weeks and twice a month for 10 months.All the patients were instructed to retain the instillation volume for at least one hour.Clinical symptoms (24 h frequency of urination,maximal micturition volume),O'Leary-Sant symptom and problem index were assessed at baseline and 1,6 and 12 months after treatment.The 2 therapies were compared within curative effects and side effects.Results Twenty-two of the 23 patients were followed up to 12 months.Patients in group A had no adverse events reported.One case of group B dropped out from treatment for recurrent urinary tract infection,and the other two cases felt painful in bladder area during instillation.There was no significant difference in initial scores between the 2 groups (P＞0.05).At 1,6,12 months after intravesical instillation,interstitial cystitis symptom index,interstitial cystitis problem index,24 h frequency of urination,the maximum bladder capacity were improved in both groups.All indicators in group A and B were improved significantly after treatment compared with pretreatment (P ＜ 0.05).≥ 25％ decrease of interstitial cystitis symptom index or ≥25％ decrease of 24 h frequency of urination were defined as remission.Remission rates of the 2 groups at each time point were1 month after treatment (100％ versus 100％,P=1.000),6 months after treatment (80％ versus 83％,P=1.000),1 year after treatment (70％ versus 75％,P=1.000).There were no significant differences between the 2 groups in all time points for the outcomes (P ＞ 0.05).Conclusion The four-drug combination intravesical instillation could achieve a similar effect with hyaluronic acid therapy in patients with IC/PBS.