“Painful bladder syndrome”: trattamento endovescicale con acido ialuronico e condroitin solfato

Aim:Painful bladder syndrome is a chronic inflammatory disease with unknown pathogenesis. Clinical signs are: urgency-frequency, disuria and sovrapubic pain with negative urine cultures. It results in defective mucous lining of the bladder epithelium made by glycosaminoglican, (GAG). We tested instillation with Hyaluronic Acid and Chondroitin Sulphate to restore a defective GAG layer.Methods:From September 2011 to July 2013 we evaluated 21 patients with dysuria. A voiding diary and visual analogue scale (VAS rating from 0 to 10) questionnaire pre and post treatment were given to patients. They were treated with weekly instillations in the first month, every 14 days in the second one and monthly for 4 months.Results:71% of patients reported bladder pain improvement. The mean initial VAS score of 7,95 decreased to 4,38 after therapy. The number of voiding decreased from 12,42 to 7 and mean voiding volumes increased from 136 ml to 253 ml showing a significant global improvement. Therapy was well tolerated and only 2 patients reported mild irritative symptoms. No adverse reactions were reported during the trial.Conclusions:significant improvement in symptoms and Quality of Life was obtained by bladder instillation with Hyaluronic Acid and Chondroitin Sulphate.