Via practica 5/2019
The use of hyaluronic acid in the treatment of cystitis
Intravesical instillation of hyaluronic acid (HA) and chondroitin sulphate (CHS) is used to supplement the glycosaminoglycan (GAG) layer in a number of indications, including the prevention of recurrent urinary tract infection (rUTI) in women, bladder pain syndrome/ interstitial cystitis (BPS/IC), overactive bladder syndrome (OAB), radiation cystitis, etc. Real data show that bladder instillations using the HA + CHS combination may reduce the risk of bacteriologically confirmed urinary tract infection (UTI) compared to current standard UTI prophylaxis management. In order to treat and prevent rUTI, there is a need for effective and safe alternative strategies for antimicrobial therapy. Although mostly retrospective, uncontrolled studies with a small number of patients do not yet provide clear conclusions, their findings highlight the importance of the need for further prospective and randomized studies in this area and highlight the promising role of intravesical HA ± CHS in preventing and treating rUTI at a time of alarmingly elevated antimicrobial resistance. HA ± CHS appears to reduce the number of UTI attacks and prolong the time to relapse in women with rUTI. Intravesical HA and HA ± CHS instillation significantly alleviated pain symptoms, improved quality of life and other results, and could be included as a therapeutic modality in individuals suffering from BPS/IC.
Keywords: hyaluronic acid, intravesical instillation, prophylaxis of recurrent urinary tract infection, treatment of bladder pain syndrome/ interstitial cystitis
