Efficacy comparison of interstitial cystitis/painful bladder syndrome patients treated with four-drug combination and sodium hyaluronate intravesical instillation

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). Conclusion The four-drug combination intravesical instillation could achieve a similar effect with hyaluro-nic acid therapy in patients with IC/PBS. Key words: Interstitial cystitis/painful bladder syndrome; Four-drug combination; Sodium hyaluronate; Intravesical instillation