[Clinical and urodynamic experience with intravesical hyaluronic acid in painful bladder syndrome associated with interstitial cystitis]. / Experiencia clínica y urodinámica con ácido hialurónico intravesical en el síndrome de vejiga dolorosa asociado a cistitis intersticial.

INTRODUCTION: few studies have been carried out on therapeutic options in patients with painful bladder syndrome associated with interstitial cystitis. The aim is to verify the safety and effectiveness of treatment with sodium hyaluronate through intravesical instillation in patients with painful bladder syndrome. MATERIALS AND METHODS: a series of 18 female patients is presented, with a mean age of 51 years and prior diagnosis of painful bladder syndrome, who were treated by means of the weekly infusion of an intravesical solution of 40mg of sodium hyaluronate in sterile solution, over a period of eight weeks. The patients were examined clinically and urodynamically prior to their inclusion in the study and eight months after the instillations had concluded. RESULTS: there was a statistically significant improvement in the urodynamic parameters and in the symptoms measured quantitatively by means of the questionnaire "Pelvic Pain and Urgency/Frequency" between the baseline situation and after the vesical instillation of sodium hyaluronate in patients with painful bladder syndrome. There was no toxicity arising from the treatment, given that no adverse effects were recorded in relation to it. CONCLUSION: the clinical use of intravesical hyaluronic acid in patients with painful bladder syndrome possibly associated with interstitial cystitis has been demonstrated. The clinical improvement is also associated both with increased bladder capacity and improved bladder sensitivity. Tolerance was excellent. Clinical tests that more profoundly evaluate the therapeutic potential of this drug in this type of patients are required.

Experiencia clínica y urodinámica con ácido hialurónico intravesical en el síndrome de vejiga dolorosa asociado a cistitis intersticial / Clinical and urodynamic experience with intravesical hyaluronic acid in painful bladder syndrome associated with interstitial cystitis

Introducción: las opciones terapéuticas en las pacientes con vejiga dolorosa asociada a cistitis intersticial están poco estudiadas. Se pretende verificar la seguridad y eficacia del tratamiento con hialuronato de sodio a través de instilación intravesical en pacientes portadoras de síndrome de vejiga dolorosa. Material y métodos: se presenta una serie de 18 pacientes femeninas, con edad media de 51 años y diagnóstico previo de síndrome de vejiga dolorosa, que fueron tratadas mediante la infusión de una solución intravesical semanal de 40mg de hialuronato de sodio en solución estéril, durante 8 semanas. Las pacientes fueron evaluadas clínica y urodinámicamente antes de su inclusión en el estudio y 8 meses después de haber finalizado las instilaciones. Resultados: se observó una mejora estadísticamente significativa en los parámetros urodinámicos y en la sintomatología medida cuantitativamente mediante el cuestionario Pelvic Pain and Urgency/Frequency entre la situación basal y después de la instilación vesical de hialuronato de sodio en paciente con síndrome de vejiga dolorosa. La toxicidad derivada del tratamiento fue nula, puesto que no se registró efecto adverso relacionado con el tratamiento. Conclusión: se demuestra la utilidad clínica del ácido hialurónico intravesical en pacientes con síndrome de vejiga dolorosa posiblemente asociado a cistitis intersticial. La mejoría clínica se asocia también con aumento de la capacidad y mejora de la sensibilidad vesical. La tolerancia fue excelente. Se necesitan ensayos clínicos que evalúen en profundidad el potencial terapéutico de este fármaco en este tipo de pacientes (AU)

Introduction: few studies have been carried out on therapeutic options in patients with painful bladder syndrome associated with interstitial cystitis. The aim is to verify the safety and effectiveness of treatment with sodium hyaluronate through intravesical instillation in patients with painful bladder syndrome. Materials and methods: a series of 18 female patients is presented, with a mean age of 51 years and prior diagnosis of painful bladder syndrome, who were treated by means of the weekly infusion of an intravesical solution of 40mg of sodium hyaluronate in sterile solution, over a period of eight weeks. The patients were examined clinically and urodynamically prior to their inclusion in the study and eight months after the instillations had concluded. Results: there was a statistically significant improvement in the urodynamic parameters and in the symptoms measured quantitatively by means of the questionnaire “Pelvic Pain and Urgency/Frequency” between the baseline situation and after the vesical instillation of sodium hyaluronate in patients with painful bladder syndrome. There was no toxicity arising from the treatment, given that no adverse effects were recorded in relation to it. Conclusion: the clinical use of intravesical hyaluronic acid in patients with painful bladder syndrome possibly associated with interstitial cystitis has been demonstrated. The clinical improvement is also associated both with increased bladder capacity and improved bladder sensitivity. Tolerance was excellent. Clinical tests that more profoundly evaluate the therapeutic potential of this drug in this type of patients are required (AU)

Impacto en la administración de un donante de óxido nítrico en gel en el flujo sanguíneo clitoridiano, medido por eco-Doppler / Impact of topic administration of nitric oxide donor gel in the clitoridian blood flow, assessed by Doppler ultra-sound

Objetivo: Evaluar el impacto de las moléculas del donante de óxido nítrico (NO) en el gel F-127 plurónico, aplicado tópicamente en el clítoris, sobre el flujo sanguíneo clitoridiano de mujeres jóvenes voluntarias, usando eco-Doppler. Método: Veinte mujeres sanas mayores de edad, sexualmente activas y sin alteraciones sexuales en su historia clínica fueron enroladas para la medición mediante eco-Doppler de la velocidad del pico sistólico, velocidad diastólica y tasa de resistencia en las arterias clitoridianas previo a la aplicación del donante del NO en gel, a fin de observar los valores basales del flujo en ellas y comparar los valores pre y post. Resultados: Las velocidades sistólica, diastólica y resistencia de base, y 15min posterior a la aplicación del gel, fueron significativamente diferentes (p=0,002, p=0,043, p=0,005, respectivamente). Los resultados muestran el aumento de las velocidades sistólicas y diastólicas a nivel de las arterias clitoridianas en casi 2,5 veces después de 15min de la administración del gel, lo que traduce un aumento en el flujo sanguíneo clitoridiano. Conclusión: El uso del donante de NO en gel S-nitrosoglutation aumenta, significativamente, el flujo sanguíneo del clítoris. Esto podría ser usado terapéuticamente en algunos casos de disfunción sexual(AU)

Objective: This study aims to evaluate of the impact of NO molecules in Pluronic F-127 gel, applied topically in the clitoris, on the clitoridian blood flow of healthy volunteer women, using the Doppler ultra-sound. Method: A total of 20 healthy women over 18 years old and sexually active with no sexual hormones alteration were enrolled. The Doppler ultra-sound procedure was performed on the artery of the clitoris in patients without the NO donor gel, and then after fifteen minutes of its application the same procedure was done again, to compare the values. Results: The hemodynamic results showed, that this formulation was responsible for the increase of the systolic and diastolic speeds in about 2,5 times after 15min of the administration of the gel. The initial resistance index was increased in 1.2 due to the local venous congestion in only 15min after the administration of gel. Indicating that this product can be used to promote the dilatation of the artery of the clitoris to treat women with sexual dysfunction. Conclusion: The use of topic hidrogel as a donor drug in the clitoris of women resulting in a local vasodilatation, without systemic effects. These findings suggest that this preparation may be useful in the management of selected cases of female sexual dysfunction(AU)

[Impact of topic administration of nitric oxide donor gel in the clitoridian blood flow, assessed by Doppler ultra-sound]. / Impacto en la administración de un donante de óxido nítrico en gel en el flujo sanguíneo clitoridiano, medido por eco-Doppler.

OBJECTIVE: This study aims to evaluate of the impact of NO molecules in Pluronic F-127 gel, applied topically in the clitoris, on the clitoridian blood flow of healthy volunteer women, using the Doppler ultra-sound. METHOD: A total of 20 healthy women over 18 years old and sexually active with no sexual hormones alteration were enrolled. The Doppler ultra-sound procedure was performed on the artery of the clitoris in patients without the NO donor gel, and then after fifteen minutes of its application the same procedure was done again, to compare the values. RESULTS: The hemodynamic results showed, that this formulation was responsible for the increase of the systolic and diastolic speeds in about 2,5 times after 15 min of the administration of the gel. The initial resistance index was increased in 1.2 due to the local venous congestion in only 15 min after the administration of gel. Indicating that this product can be used to promote the dilatation of the artery of the clitoris to treat women with sexual dysfunction. CONCLUSION: The use of topic hidrogel as a donor drug in the clitoris of women resulting in a local vasodilatation, without systemic effects. These findings suggest that this preparation may be useful in the management of selected cases of female sexual dysfunction.