No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
534Comparative assessment of maximal bladder capacity, 0.9% NaCl VS. 0.2 M KCl before and after therapy for interstitial cystitis
... Without an evidenced explanation for this phenomenon, it may be hypothesised that, in part of IC/PBS patients, timely GAG substitution may restore the urothelial or GAG defect, while in case of continuous damage to the urine–tissue barrier, GAG substitution therapy has either to be administered continuously or stays ineffective. This theory is supported by the observation that potassium-positive patients with symptom remission after GAG substitution therapy turn potassium-negative, which suggests normalisation of the urine–tissue barrier disorder, while non-responders stay potassium-positive after therapy [21, 22]. While side effects from hyaluronan as a biologic substance normally found in the bladder and other tissues are very improbable, the biochemical properties suggest superior efficacy compared to other GAG substituents. ...
The aim of this study is to evaluate the efficacy of intravesical hyaluronan therapy in interstitial cystitis/painful bladder syndrome (IC/PBS). One hundred twenty-six patients with IC/PBS and an average disease duration of 6.1 years were treated with weekly instillations of a 50-cm3 phosphate-buffered saline solution containing 40 mg sodium hyaluronate. To be eligible for hyaluronan treatment, a positive modified potassium test was requested as a sign of a urine-tissue barrier disorder. Data were obtained by a visual analogue scale (VAS) questionnaire rating from 0 to 10 that asked for global bladder symptoms before and after therapy. Additional questions evaluated the therapeutic impact on quality of life. A positive and durable impact of hyaluronan therapy on IC/PBS symptoms was observed--103 (85%) of the patients reported symptom improvement (> or =2 VAS units). The mean initial VAS score of 8.5 decreased to 3.5 after therapy (p < 0.0001). Out of 121 patients, 67 (55%) remained with no or minimal bladder symptoms after therapy (VAS 0-2). The majority (101, 84%) reported significant improvement of their quality of life. Intravesical therapy had to be initiated again with good success in 43 patients (34.5%) as symptoms recurred after discontinuation of treatment, while the rest stayed free of symptoms for up to 5 years. In general, hyaluronan therapy was well tolerated and, with the exception of mild irritative symptoms, no adverse reactions were reported for a total of 1,521 instillations. Timely hyaluronan instillation therapy may lead to complete symptom remission or even cure in part of the IC/PBS patients, while some responders need continuous intravesical therapy. The present results suggest that selection of patients for hyaluronan therapy by potassium testing improves the outcome of intravesical therapy with a response rate of >80%.
ResearchGate has not been able to resolve any references for this publication.