1871 TESTING THE EFFICACY OF INTRAVESICAL HYALURONIC ACID INSTILLATIONS IN THE PREVENTION OF RECURRENT URINARY TRACT INFECTIONS

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Female Urology1 Apr 20111871 TESTING THE EFFICACY OF INTRAVESICAL HYALURONIC ACID INSTILLATIONS IN THE PREVENTION OF RECURRENT URINARY TRACT INFECTIONS Antonia Centemero, Lorenzo Rigatti, Giovanni Lughezzani, Alessandro Larcher, Giuliana Lista, Massimo Lazzeri, Patrizio Rigatti, Francesco Montorsi, and Giorgio Guazzoni Antonia CentemeroAntonia Centemero Milan, Italy More articles by this author , Lorenzo RigattiLorenzo Rigatti Milan, Italy More articles by this author , Giovanni LughezzaniGiovanni Lughezzani Milan, Italy More articles by this author , Alessandro LarcherAlessandro Larcher Milan, Italy More articles by this author , Giuliana ListaGiuliana Lista Milan, Italy More articles by this author , Massimo LazzeriMassimo Lazzeri Milan, Italy More articles by this author , Patrizio RigattiPatrizio Rigatti Milan, Italy More articles by this author , Francesco MontorsiFrancesco Montorsi Milan, Italy More articles by this author , and Giorgio GuazzoniGiorgio Guazzoni Milan, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1953AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Hyaluronic acid constitutes an important proportion of bladder surface glycosaminoglycans and represents a barrier of the urothelium that may help to prevent urinary tract infection (UTI). Damage to this layer has been postulated as a causative factor in the development of recurrent UTI. To date, few studies addressed the role of hyaluronic acid in patients with recurrent cystitis. We tested the efficacy of intravesical hyaluronic acid instillation against recurrent UTI in a contemporary group of patients referred to our Institution. METHODS Between January 2006 an January 2009, we recruited 48 fertile women with recurrent cystitis who received 8 instillations (once weekly for 8 weeks) of hyaluronic acid HA (CystistatR, Bioniche Life Sciences Inc, Belleville, Ontario, Canada) at the dose of 40 mg in 50 mL of phosphate buffered saline solution. All patients had a clinical history of recurrent cystitis, defined as at least 3 episodes of uncomplicated cystitis with clinical symptoms and a positive culture for each episode, according to the European Association of Urology guidelines. In all patients, recurrent UTIs were lasting from at least 15 months, with a frequency of 1 episode every 4–6 weeks. All patients were prospectively evaluated over an 18 months follow-up period. RESULTS Mean age was 36.91 years (range 25–48 years). The most commonly diagnosed pathogen was E. Coli (76%). After the 8-week therapy, 36 patients (75.0%) were free of their disease and did not show any clinical and cultural recurrence during the 18 months follow-up period. Conversely, 10 patients (20.8%) showed a recurrence of their disease during the follow up period. However, in this patient category, the mean time to recurrence significantly increased from 39.85 days (range 23–55 days) before treatment to 190.64 days (range 170–211 days) after treatment (p-value <0.001). Finally, 2 patients (4.2%) experienced a recurrence during the 8 weeks of intravesical instillations. All patients tolerated the instillations well and no serious adverse events were reported during the study period. CONCLUSIONS Intravescical hyaluronic acid instillations appears to be a safe and feasible therapeutic option that strongly reduce the incidence of recurrent UTI in fertile women. Prospective randomized studies are still needed to further validate our results. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e750-e751 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Antonia Centemero Milan, Italy More articles by this author Lorenzo Rigatti Milan, Italy More articles by this author Giovanni Lughezzani Milan, Italy More articles by this author Alessandro Larcher Milan, Italy More articles by this author Giuliana Lista Milan, Italy More articles by this author Massimo Lazzeri Milan, Italy More articles by this author Patrizio Rigatti Milan, Italy More articles by this author Francesco Montorsi Milan, Italy More articles by this author Giorgio Guazzoni Milan, Italy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...