Skip to main content Skip to main navigation menu Skip to site footer

The Comparison of intravesical hyaluronic acid and other modalities for the improvement of interstitial cystitis symptoms: a systematic reviews and meta-analysis

Abstract

Background: Interstitial cystitis (IC) is a chronic inflammation of the bladder which causes unpleasant sensations. This condition considerably reduces patients' quality of life. Intravesical hyaluronic acid is one of the new interventions for interstitial cystitis management, in which a thorough review and meta-analysis regarding this topic are still limited. This study aimed to compare the efficacy of intravesical hyaluronic acid with other intravesical treatment modalities available to treat interstitial cystitis.

Method: Systematic literature searching with the main keywords of "interstitial cystitis" or "bladder pain syndrome" and "intravesical hyaluronic acid" was conducted. The main outcome of this study was pain assessment using a visual analogue scale (VAS) and Interstitial Cystitis Symptoms Index (ICSI), and problem index (ICPI). Meta-analysis was carried out when comparative studies were available. Eleven studies were obtained to assess intravesical hyaluronic acid's effects, including three in the meta-analysis. The intravesical treatments found as a comparison were heparin and chondroitin sulphate.

Result: There was significant heterogeneity among studies included in all parameters. The pooled analysis showed no significant difference in VAS reduction, improvement of ICSI and ICPI score (p = 0.11, p = 0.35, and p = 0.28, respectively) between hyaluronic acid and other intravesical treatments.

Conclusion: There was no significant difference between hyaluronic acid and other intravesical treatments. However, further research with a larger sample is needed to confirm the best modalities in interstitial cystitis.

References

  1. Nordling J, Fall M, Hanno P. Global concepts of bladder pain syndrome (interstitial cystitis). World J Urol. 2012;30(4):457-64. http://dx.doi.org/10.1007/s00345-011-0785-x.
  2. Lazzeri M, Montorsi F. The therapeutic challenge of "chronic cystitis": search well, work together, and gain results. Eur Urol. 2011;60(1):78-80. http://dx.doi.org/10.1016/j.eururo.2011.03.039.
  3. Berry SH, Elliott MN, Suttorp M, Bogart LM, Stoto MA, Eggers P, et al. Prevalence of symptoms of bladder pain syndrome/interstitial cystitis among adult females in the United States. The Journal of urology. 2011;186(2):540-4. http://dx.doi.org/10.1016/j.juro.2011.03.132.
  4. Giannantoni A, Bini V, Dmochowski R, Hanno P, Nickel JC, Proietti S, et al. Contemporary management of the painful bladder: a systematic review. Eur Urol. 2012;61(1):29-53. http://dx.doi.org/10.1016/j.eururo.2011.07.069.
  5. Mahmoud MS. Bladder pain syndrome/interstitial cystitis: a reappraisal for the clinician. J Reprod Med. 2011;56(9-10):405-9.
  6. Hanno PM, Burks DA, Clemens JQ, Dmochowski RR, Erickson D, Fitzgerald MP, et al. AUA guideline for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome. J Urol. 2015 May;193(5):1545-53. http://dx.doi.org/10.1016/j.juro.2011.03.064.
  7. Lazzeri M, Hurle R, Casale P, Buffi N, Lughezzani G, Fiorini G, et al. Managing chronic bladder diseases with the administration of exogenous glycosaminoglycans: an update on the evidence. Ther Adv Urol. 2016;8(2):91-9. http://dx.doi.org/10.1177/1756287215621234.
  8. Pyo JS, Cho WJ. Systematic review and meta-analysis of intravesical hyaluronic acid and hyaluronic acid/chondroitin sulfate instillation for interstitial cystitis/painful bladder syndrome. Cell Physiol Biochem. 2016;39(4):1618-25. http://dx.doi.org/10.1159/000447863.
  9. Shao Y, Shen ZJ, Rui WB, Zhou WL. Intravesical instillation of hyaluronic acid prolonged the effect of bladder hydrodistention in patients with severe interstitial cystitis. Urology. 2010;75(3):547-50. http://dx.doi.org/10.1016/j.urology.2009.09.078.
  10. Parsons CL, Lilly JD, Stein P. Epithelial dysfunction in nonbacterial cystitis (interstitial cystitis). J Urol. 1991;145(4):732-5. http://dx.doi.org/10.1016/s0022-5347(17)38437-9.
  11. Akbay E, Çayan S, K?l?nç C, Bozlu M, Tek M, Efesoy O. The short-term efficacy of intravesical instillation of hyaluronic acid treatment for bladder pain syndrome/interstitial cystitis. Turk J Urol. 2018;45(2):129-34. http://dx.doi.org/10.5152/tud.2018.35920 .
  12. Gulpinar O, Kayis A, Suer E, Gokce MI, Guclu AG, Arikan N. Clinical comparision of intravesical hyaluronic acid and hyaluronic acid-chondroitin sulphate therapy for patients with bladder pain syndrome/interstitital cystitis. Can Urol Assoc J. 2014;8(9-10):E610-4. http://dx.doi.org/10.5489/cuaj.2036.
  13. Ali Z and Hotasi S. Association between age, urine pH, and urinary stone incidence in Kardinah Tegal General Hospital, Indonesia. Intisari Sains Medis 2020;11(3): 958-962. DOI:10.15562/ism.v11i3.790
  14. Riedl CR, Engelhardt PF, Daha KL, Morakis N, Pfluger H. Hyaluronan treatment of interstitial cystitis/painful bladder syndrome. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(5):717-21. http://dx.doi.org/10.1007/s00192-007-0515-5.
  15. Engeler D, Baranowski AP, Berghmans B, Borovicka J, Cottrell AM, Dinis-Oliveira P, et al. EAU Guidelines on Chronic Pelvic Pain. The Netherlands: EAU Guidelines Office; 2020.
  16. Rahardjo HE. [Bladder pain syndrome management guidelines]. Jakarta: Ikatan Ahli Urologi Indonesia; 2019. Avaliable from: https://www.iaui.or.id/guidelines/[2019]%20Panduan%20Tatalaksana%20Sindrom%20Nyeri%20Kandung%20Kemih.pdf

How to Cite

Ariwicaksono, S. C., & Rahardjo, H. E. (2021). The Comparison of intravesical hyaluronic acid and other modalities for the improvement of interstitial cystitis symptoms: a systematic reviews and meta-analysis. Bali Medical Journal, 10(3), 970–974. https://doi.org/10.15562/bmj.v10i3.2510

HTML
0

Total
0

Share

Search Panel

St Cahyo Ariwicaksono
Google Scholar
Pubmed
BMJ Journal


Harrina Erlianti Rahardjo
Google Scholar
Pubmed
BMJ Journal