Factors associated with treatment outcomes after intravesical hyaluronic acid therapy in women with refractory interstitial cystitis: A prospective, multicenter study

Ching Pei Tsai, Jenn Ming Yang, So Jung Liang, Yi Hao Lin, Wen Chu Huang, Tzu Yin Lin, Chun Shuo Hsu, Fei Chi Chuang, Man Jung Hung

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Background: Bladder instillation of hyaluronic acid (HA) is an acceptable treatment for bladder pain syndrome/interstitial cystitis (BPS/IC). The treatment is limited by a high proportion of non-responders (~30%–40%). Here, we aimed to evaluate predisposing factors associated with treatment outcomes. Methods: This is a prospective multicenter study. We enrolled a total of 137 (out of 140) women with refractory IC. They all underwent a standard protocol of 6-month intravesical HA therapy (initial 4 weeks, once weekly, followed by once monthly). To assess the outcomes, we used the pain Visual Analog Scale (Pain-VAS), Interstitial Cystitis Symptom and Problem Index (ICSI & ICPI), and a scaled Global Response Assessment (GRA). Results: The age of patients was 47.6 ± 27.5 (range 24–77) years. We found statistically significant improvement (p < 0.001) in the Pain-VAS and the ICSI & ICPI scores both after the initial 4-weekly instillations and at the end of 6-month treatment. Those who reported moderate/marked improvement on GRA at the 2 follow-up visits were considered responders: 39.4% (n = 54) at the first follow-up, and 59.9% (n = 82) at the second follow-up. No remarkable side effect was noted. After statistical analyses, treatment outcomes on GRA were positively associated with baseline functional bladder capacity and with Pain-VAS scores. The initial treatment responses optimally (p < 0.001) predicted final treatment outcomes (McNemar). Conclusion: Intravesical HA therapy is safe and effective for most (~60%) of our patients with refractory IC. Functional bladder capacity and Pain-VAS scores before treatment, and the early treatment responses are helpful predictors of treatment outcomes.

Original languageEnglish
JournalJournal of the Chinese Medical Association
Volume84
Issue number4
DOIs
Publication statusPublished - Apr 1 2021

Keywords

  • Bladder pain syndrome
  • Hyaluronic acid
  • Interstitial cystitis
  • Intravesical therapy
  • Treatment outcome

ASJC Scopus subject areas

  • Medicine(all)

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