Efficacy assessment of bladder hydrodistension combined with drug intravesical instillation for treatment of interstitial cystitis/bladder pain syndrome
CHEN Qiang, ZHOU Shuyin, ZHANG Mao, and LIU Deyun
Department of Urology,Chongqing Municipal Corps Hospital of Chinese People’s Armed Police Forces, Chongqing 400061, China
Abstract：Objective To explore the efficacy of bladder hydrodistension combined with drug intravesical therapy in treatment of IC/BPS. Methods O’ Leary-Sant questionnaire and PUF were used to assess the patients’ symptoms. Depending on the intravesical drugs, the patients were divided into groups A and B. To group A, hyaluronic acid was administered intravesically; To group B, heparin cocktail was given intravesically. The efficacy was comparied between the two groups before and after treatment. Results After 6 months of treatment, the total effective rates were 88.6%(group A) and 86.1%(B group) respectively.Comparing the total effective rates of the two groups, there was no statistically significant difference (P=0.074). Compared with before treatment, the observed indicators in the two groups of patients were improved(P<0.05) after treatment at 1,3,6 months. 1 month after treatment, the difference between the two groups was not significant (P>0.05), 3 months and 6 months after treatment, differences between the two groups were statistically significant(P<0.05). Conclusions Hydrodistension combined with intravesical instillation of hyaluronic acid or heparin cocktail method can effectively alleviate the symptoms of patients with IC/BPS; hyaluronic acid is superior to heparin cocktail method in the long-term efficacy.
Giannantoni A, Bini V, Dmochowski R, et al. Contemporary management of the painful bladder: a systematic review[J].Eur Urol,2012,61(1):29-53.
[12]
Kuo H C. Urodynamic results of intravesical heparin therapy for women with frequency urgency syndrome and interstitial cystitis[J]. J Formos Med Assoc, 2001,100(5):309-314.
[2]
Gillenwater J Y, Wein A J.Summary of the National Institute of Arthritis, Diabetes, Digestive and Kidney Diseases Workshop on Interstitial Cystitis, National Institutes of Health, Bethesda, Maryland, August 28-29,1987[J].J Urol,1988,140(1):203-206.
[13]
Asklin B, Cassuto J.Intravesical lidocaine in severe interstitial cystitis. Case report[J].Scand J Urol Nephrol,1989,23(4):311-312.
Nickel J C, Moldwin R, Lee S, et al. Intravesical alkalinized lidocaine (PSD597) offers sustained relief from symptoms of interstitial cystitis and painful bladder syndrome[J]. BJU Int,2009,103(7):910-918.
[4]
Nordling J, Anjum F H, Bade J J, et al. Primary evaluation of patients suspected of having interstitial cystitis (IC)[J]. Eur Urol, 2004,45(5):662-669.
[15]
Taneja R.Intravesical lignocaine in the diagnosis of bladder pain syndrome[J].Int Urogynecol J,2010,21(3):321-324.
[5]
Bumpus H J.Interstitial cystitis: its treatment by overdistention of the bladder[J].Med Clin North Am,1930,13:1495-1498.
[16]
Riedl C R, Engelhardt P F, Daha K L,et al.Hyaluronan treatment of interstitial cystitis/painful bladder syndrome[J].Int Urogynecol J Pelvic Floor Dysfunct,2008,19(5):717-721.
[6]
Tomoe H, Kobayashi H, Nakazawa H, et al. The efficacy of hydro-distention of the bladder for interstitial cystitis[J]. J Interst Cyst,2004,2(11):24-31.
[7]
Glemain P, Riviere C, Lenormand L, et al. Prolonged hydrodistention of the bladder for symptomatic treatment of interstitial cystitis: efficacy at 6 months and 1 year[J]. Eur Urol, 2002,41(1):79-84.
[8]
Yamada T, Murayama T, Andoh M. Adjuvant hydrodistension under epidural anesthesia for interstitial cystitis[J].Int J Urol,2003,10(9):463-468.
[9]
Hsieh C H, Chang W C, Huang M C, et al.Hydrodistention plus bladder training versus hydrodistention for the treatment of interstitial cystitis[J].Taiwan J Obstet Gynecol, 2012,51(4):591-595.
[10]
Chai T C, Zhang C O, Shoenfelt J L, et al. Bladder stretch alters urinary heparin-binding epidermal growth factor and antiproliferative factor in patients with interstitial cystitis[J]. J Urol, 2000,163(5):1440-1444.
[11]
Parsons C L,Bautista S L,Stein P C,et al. Cyto-injury factors in urine: a possible mechanism for the development of interstitial cystitis[J].J Urol, 2000,164(4):1381-1384.
[12]
Kuo H C. Urodynamic results of intravesical heparin therapy for women with frequency urgency syndrome and interstitial cystitis[J]. J Formos Med Assoc, 2001,100(5):309-314.
[13]
Asklin B, Cassuto J.Intravesical lidocaine in severe interstitial cystitis. Case report[J].Scand J Urol Nephrol,1989,23(4):311-312.
[14]
Nickel J C, Moldwin R, Lee S, et al. Intravesical alkalinized lidocaine (PSD597) offers sustained relief from symptoms of interstitial cystitis and painful bladder syndrome[J]. BJU Int,2009,103(7):910-918.
[15]
Taneja R.Intravesical lignocaine in the diagnosis of bladder pain syndrome[J].Int Urogynecol J,2010,21(3):321-324.
[16]
Riedl C R, Engelhardt P F, Daha K L,et al.Hyaluronan treatment of interstitial cystitis/painful bladder syndrome[J].Int Urogynecol J Pelvic Floor Dysfunct,2008,19(5):717-721.
2014, Vol. 25 
