Urinary and psychological outcomes in women with interstitial cystitis/bladder pain syndrome following hyaluronic acid treatment

Taiwan J Obstet Gynecol. 2018 Jun;57(3):360-363. doi: 10.1016/j.tjog.2018.04.006.

Abstract

Objective: To investigate urinary and psychological symptoms in patients with interstitial cystitis/bladder pain syndrome (IC/BPS) after intravesical hyaluronic acid (HA) treatment.

Materials and methods: Thirty patients with newly diagnosed with IC/BPS undergoing 4 weekly intravesical HA instillations followed by 5 monthly instillations were recruited. Pre-treatment evaluation included a urinalysis and urinary culture, a 3-day voiding diary, and cystoscopy with hydrodistention of the bladder. Questionnaires containing hospital anxiety and depression scale (HADS), O'Leary-Sant score, Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ-12), and a pain visual analog scale were completed before and after treatment. Thirty age-matched, asymptomatic women were recruited as controls for assessing HADS scores, and comparison of urinary and psychological symptoms in patients before and after HA treatment.

Results: The mean age (range 25-71 years old) and symptomatic duration (range 1-11 years) were 47 and 4.5, respectively. When compared with the control group, patients with IC/BPS had a significant increase in HADS depression subscale score and total score. Frequency, nocturia, bladder capacity, IC symptom and problem index scores, and pain score improved after 6 months of intravesical HA treatment. After HA treatment, 73% (n = 22) of patients showed improvement in their urological symptoms, but no significant changes were found in their HADS and PISQ-12 scores.

Conclusions: Bladder pain and lower urinary tract symptoms in patients with IC/BPS may improve after a 6-month intravesical HA treatment. However, no significant changes in their psychological and sexual functional scores were found.

Keywords: Anxiety; Bladder pain syndrome; Depression; Hyaluronic acid; Interstitial cystitis.

MeSH terms

  • Adjuvants, Immunologic / administration & dosage*
  • Administration, Intravesical
  • Adult
  • Anxiety / complications
  • Anxiety / diagnosis
  • Case-Control Studies
  • Cystitis, Interstitial / complications
  • Cystitis, Interstitial / drug therapy*
  • Cystitis, Interstitial / psychology
  • Depression / complications
  • Depression / diagnosis
  • Female
  • Humans
  • Hyaluronic Acid / administration & dosage*
  • Middle Aged
  • Nocturia / complications
  • Pain / drug therapy*
  • Pain Measurement
  • Prospective Studies
  • Surveys and Questionnaires
  • Urinary Bladder / drug effects
  • Urinary Bladder / physiopathology

Substances

  • Adjuvants, Immunologic
  • Hyaluronic Acid