Intravesical instillation of sodium hyaluronate for the treatment of refractory non-bacterial cystitis:a multicenter study / 中华泌尿外科杂志

ABSTRACT

Objective To evaluate the efficacy and safety of intravesical instillation of sodium hya- luronate in relieving the symptoms of refractory non-bacterial cystitis.Methods Totally,20 patients(1 man and 19 women;mean age,47 years;age range,22-68 years)with refractory non-bacterial cystitis were included.Their disease course ranged from 1 month to 30 years.Of them,16 patients had the disease for more than 1 year.Instillation of sodium hyaluronate(50 ml solution of 40 mg HA)was performed intravesically in them for a total of 12 weeks(once a week for the first 4 weeks and once every 4 weeks for the succeeding 8 weeks).Follow-up visit ended at 16 weeks,when the patients filled in the symptom assessment scores(VAS on pain,frequency and urgency)according to the subjective evaluation.Therapeutic results were classified as(1)total responsesymptom disappearance or relief by at least 90% of the symptom scores;(2)partial responsesymptom relief by 50%-89%;(3)mild responsesymptom relief by 49% or less;(4)no re- sponseno improvement in symptom scores.Results Nineteen patients completed the 16-week follow-up with only 1 withdrawing.The average general symptom score decreased from 22.32?5.53 to 9.47?5.88 (P＜0.001);frequency score from 8.21?1.75 to 3.89v2.31(P＜0.001);urgency score from 7.47?2.14 to 3.37?2.14(P＜0.001);pain score from 6.63?3.47 to 2.21?2.74(P＜0.001).After 16 weeks,overall positive response rate(total+partial response)was 53%(10/19).No serious adverse effect occurred except for urethral irritation(25%,5/20),worsening of distending pain of the bladder(5%,1/20) and vertigo(15%,3/20)caused by the procedure itself.Conclusions For patients suffering from refrac- tory non-bacterial cystitis,intravesical instillations of sodium hyaluronate can significantly relieve the symp- toms and is safe and of good patient compliance.