Safety and dose flexibility clinical evaluation of intravesical liposome in patients with interstitial cystitis or painful bladder syndrome. Intravesical hyaluronic acid and alkalinized lidocaine for the treatment of severe painful bladder syndrome/interstitial cystitis The Clinical Effectiveness of Intravesical Sodium Hyaluronate (Cystistat®) in Patients with Interstitial Cystitis/Painful Bladder Syndrome and Recurrent Urinary Tract Infections Two-year efficacy and safety of botulinum a toxin intravesical injections in patients affected by refractory painful bladder syndrome. Botulinum A toxin intravesical injections for painful bladder syndrome: impact upon pain, psychological functioning and Quality of Life.
To present single institution open-label experience with intravesical liposomes ( LPs ) , a mucosal protective agent , in patients with interstitial cystitis/painful bladder syndrome ( IC/PBS ) and to assess the safety and efficacy on IC/PBS symptoms . A total of 17 symptomatic IC/PBS patients were treated with intravesical LPs ( 80mg/40mL distilled water ) once a week for 4 weeks ( n=12 ) or twice a week treatment for 4 weeks ( n=5 ) . The primary outcome was the change in the O'Leary-Sant Symptom/Problem score and O'Leary-Sant total Score from baseline to Week 4 and Week 8 . Other outcome measurements included the changes in pain scale , urgency scale , voiding log , and patient global assessment . Both weekly and biweekly LP instillation regiments were well tolerated . The incidence of urinary incontinence , retention , or unanticipated adverse changes was not noted at any dose either during the treatment or at the 4-week follow-up . The O'Leary-Sant Symptom/Problem score , O'Leary-Sant total Score , and pain score were significantly improved from baseline at both dose regimens with added benefit with the biweekly regimen . Intravesical LPs treatment is safe and its efficacy has sustained duration . Furthermore large-scale , placebo-controlled studies are warranted to assess the efficacy for this promising new treatment for IC/PBS Introduction and hypothesisIntravesical instillation of hyaluronic acid ( HA ) may restore the integrity of glycosaminoglycan layer in patients with painful bladder syndrome/interstitial cystitis ( PBS/IC ) , and the benefit may be improved with addition of alkalinized lidocaine ( AL ) . Methods 48 women with severe PBS/IC who failed oral medications were enrolled and divided into one trial and two control groups . The trial group received intravesical 40 mg HA , 10 ml of 2 % lidocaine and 5 ml of 8.4 % sodium bicarbonate on a weekly basis for 8 weeks and then monthly for 4 months with a subsequent follow-up of 24 weeks , while the two control groups received 40 mg HA and mixture of 10 ml of 2 % lidocaine and 5 ml of 8.4%sodium bicarbonate respectively following the same procedure . Response to therapy was evaluated by Global Response Assessment , voids per day , Visual Analogue Scale for pain , frequency and urgency , O’leary-Sant Interstitial Cystitis Symptom Index and Problem Index , cystoscopy and bladder capacity . Results Overall 45 patients finished this study protocol . The HA + AL group and the AL group showed significant improvement at week 2 ( P < 0.01 ) , while the HA group began to show effect at week 4 ( P < 0.01 ) . There was no improvement in the AL group at week 24 and these patients quitted the study without follow up . Contrarily , the HA + AL and HA group kept on improving till the end of the study without significant difference between the two groups . Conclusions Intravesical instillation of HA and AL may provide both immediate and sustained relief of symptoms in severe PBS/IC in this preliminary study Objective : Painful bladder syndrome/interstitial cystitis ( PBS/IC ) and recurrent urinary tract infections ( UTI ) are clinical ly challenging conditions to manage in patients . We evaluate the clinical use of intravesical sodium hyaluronate ( Cystistat ® ) in both these patient groups who have completed treatment . Patients and Methods : Thirteen patients with recurrent UTIs ( Group I ) and 8 patients with PBS/IC ( Group II ) received intravesical sodium hyaluronate ( Cystistat ® ) . Preinstallation demographic parameters were statically comparable in both groups . The mean age of presentation was 54.6 years in Group I and 57.5 years in Group II ( p = 0.9 ) . All 13 patients in Group I were on low dose antibiotics . The mean number of installations completed in both groups was 9 ( range 4–21 ) . Results : Data was collected prospect ively using a st and ard pre- and post-treatment question er with the pelvic pain and urinary/frequency patient symptom scale . At a mean follow-up of 21 months a significant improvement in bladder pain ( p = 0.05 ) , daytime frequency ( p = 0.03 ) and quality of life ( p = 0.02 ) was noted in patients in Group I. Two patients had breakthrough UTIs during treatment . Within Group I , 7 ( 53 % ) patients responded well to treatment . Patients in Group II had a significant improvement in bladder pain ( p = 0.02 ) , urgency ( p = 0.01 ) , nocturia ( p = 0.01 ) and quality of life ( p = 0.04 ) . Within Group II , 6 patients ( 75 % ) responded to treatment . Conclusion : Intravesical sodium hyaluronate ( Cystistat ® ) can be used with minimal side effects and good compliance in both groups of patients with PBS and recurrent UTIs . Longer follow-up and larger patient numbers in both groups will be required to confirm the long-term efficacy of these two clinical ly challenging groups of patients INTRODUCTION AND AIM We report the 2-year efficacy and tolerability of intravesical botulinum A toxin ( BoNT/A ) injections in patients with painful bladder syndrome ( PBS ) associated with increased urinary frequency refractory to conventional treatments . MATERIAL S AND METHODS Thirteen women were prospect ively included in the study . The preliminary assessment included voiding diary , urodynamics , urinary tract ultrasound and the visual analog scale ( VAS ) for pain quantification . All patients received multiple injections of 200 U commercially available BoNT/A diluted in 20 ml 0.9 % NaCl , under cystoscopic guidance .  Clinical evaluation , urodynamics , urinary tract ultrasound and VAS were repeated at least two times per year throughout the follow-up . RESULTS A total of 58 injections were administered with a mean of 4.8 + /- 0.8 injections per patient . The mean interval between two consecutive injections was 5.25 + /- 0.75 months . At 1 and 4 mo follow up ten patients reported a subjective improvement . Mean VAS scores , mean daytime and night-time urinary frequency decreased significantly . Nine patients at 1 month and seven at the 4-month check-up complained of dysuria . The three non-responders to the first intravesical treatment session underwent another three months later with satisfactory results . At 1 and 2 years follow up the beneficial effects persisted in all patients . We did not observe any systemic side effects during the observation time . CONCLUSIONS Intravesically injected BoNT/A is effective and safe in the medium-term management of patients with PBS . As the beneficial effect decreased progressively within a few months after treatment , repeat injections of the neurotoxin were needed over time INTRODUCTION To assess the impact of intravesically injected botulinum A toxin ( BoNT/A ) upon bladder pain , urological complaints , symptoms of anxiety and depression , and Quality of Life ( QoL ) in patients with painful bladder symptoms ( PBS ) refractory to conventional treatment . PATIENTS AND METHODS In this prospect i ve study 14 patients received one injection of BoNT/A ( 200 U diluted in 20 ml 0.9 % NaCl ) , under cystoscopic guidance . At pre- and 3 months post- treatment all patients underwent an urological assessment ( voiding diary , urodynamics ) , a pain quantification on a visual analog scale ( VAS ) , an evaluation with the 14-item Hamilton Anxiety Rating Scale ( HAM-A ) to assess symptoms of psychic and somatic anxiety , an evaluation with the Hamilton Depression Rating Scale ( HAM-D ) to assess depression , and the 36-item Medical Outcomes Study Short Form ( SF-36 ) to assess QoL. Results . At pre-treatment all 14 patients had increased daytime and nighttime urinary frequency and high VAS scores . Nine patients had pathological HAM-A scores and all had pathological HAM-D scores . At the 3-month follow-up 10/14 patients reported a subjective improvement in pain . Mean VAS score , mean daytime and nighttime urinary frequency decreased significantly ( p < 0.01 , < 0.01 and < 0.01 , respectively ) . All domains in SF-36 and HAM-A significantly improved ( p<0.01 ) . All domains , except weight and sleep disorders , significantly improved in HAM-D , particularly somatoform symptoms ( p<0.01 ) , cognitive performance ( p<0.01 ) , and circadian variations ( p<0.01 ) . CONCLUSION In patients with refractory PBS with symptoms of anxiety , depression and poor QoL , BoNT/A intravesical treatment reduced bladder pain , improved psychological functioning , and well-being
Meta- analysis of BCG therapy showed improvement in symptoms according to the Wisconsin Interstitial Cystitis Symptom Inventory , but no difference in 24-h urinary frequency .
Conclusions Meta- analysis showed an improvement exclusively of the symptoms as measured by the Wisconsin Interstitial Cystitis Inventory , but not in 24-h urinary frequency , with BCG therapy .
Introduction and hypothesisThe objective of the study was to assess the effectiveness of intravesical treatment for painful bladder syndrome ( PBS ) .