Postmenopausal recurrent cystitis treatment with intravesical hyaluronic acid and chondroitin sulphate: a patient-reported outcome study

BACKGROUND: Treatment with intravesical hyaluronic acid (HA) and chondroitin sulfate (CS) may provide regeneration of the damaged glycosaminoglycan layer (GAGs) in postmenopausal women affected by recurrent cystitis (RC). METHODS: Ten postmenopausal women from 55 to 85 years of age diagnosed with RC were enrolled in a single center and clinically evaluated through the Lower Urinary Tract Infections Recurrence (LUTIRE) score. Six subjects had a LUTIRE score ranging from 71 to 99 (i.e., very high probability of recurrence), while 4 scored from 46 to 70 (i.e., medium chance). Patients received intravesical instillations of Ialuril® Prefill (IBSA Farmaceutici Italia, Lodi, Italy; i.e., HA 800 mg, CS 1 gr, CC 440 mg) in 50 mL saline solution once a week for the first four weeks, followed by administration every two weeks. Quality of Life (QoL), Visual Analogue Scale (VAS), Pelvic Pain Urgency and Frequency (PUF) score, Acute Cystitis Symptom Score (ACSS), and Female Sexual Function Index (FSFI) were assessed through validated questionnaires at baseline and at the end of the treatment cycle. RESULTS: Overall results show improvements in terms of QoL (i.e., mean difference -10.7), a sharp decrease in VAS (i.e., mean difference -10.7), PUF (i.e., mean difference -8.2), and ACSS score (i.e., mean difference -9.6), with at least 30% of subjects experiencing a 50% improvement in each of the administered questionnaires, and a clear benefit as to FSFI (i.e., mean difference +17.7). Treatment was well tolerated. CONCLUSIONS: In this experience, treatment of RC in postmenopausal women with Ialuril® Prefill (IBSA Farmaceutici Italia) was effective and well tolerated.