Intravesical hyaluronic acid and alkalinized lidocaine for the treatment of severe painful bladder syndrome/interstitial cystitis

Introduction and hypothesis

Intravesical instillation of hyaluronic acid (HA) may restore the integrity of glycosaminoglycan layer in patients with painful bladder syndrome/interstitial cystitis (PBS/IC), and the benefit may be improved with addition of alkalinized lidocaine (AL).

Methods

48 women with severe PBS/IC who failed oral medications were enrolled and divided into one trial and two control groups. The trial group received intravesical 40?mg HA, 10?ml of 2?% lidocaine and 5?ml of 8.4?% sodium bicarbonate on a weekly basis for 8?weeks and then monthly for 4?months with a subsequent follow-up of 24?weeks, while the two control groups received 40?mg HA and mixture of 10?ml of 2?% lidocaine and 5?ml of 8.4%sodium bicarbonate respectively following the same procedure. Response to therapy was evaluated by Global Response Assessment, voids per day, Visual Analogue Scale for pain, frequency and urgency, O??leary-Sant Interstitial Cystitis Symptom Index and Problem Index, cystoscopy and bladder capacity.

Results

Overall 45 patients finished this study protocol. The HA + AL group and the AL group showed significant improvement at week 2 (P?P?Conclusions Intravesical instillation of HA and AL may provide both immediate and sustained relief of symptoms in severe PBS/IC in this preliminary study.