Objective To explore the efficacy of bladder hydrodistension combined with drug intravesical therapy in treatment of IC/BPS. Methods O’ Leary-Sant questionnaire and PUF were used to assess the patients’ symptoms. Depending on the intravesical drugs, the patients were divided into groups A and B. To group A, hyaluronic acid was administered intravesically; To group B, heparin cocktail was given intravesically. The efficacy was comparied between the two groups before and after treatment. Results After 6 months of treatment, the total effective rates were 88.6%(group A) and 86.1%(B group) respectively.Comparing the total effective rates of the two groups, there was no statistically significant difference (P=0.074). Compared with before treatment, the observed indicators in the two groups of patients were improved(P<0.05) after treatment at 1,3,6 months. 1 month after treatment, the difference between the two groups was not significant (P>0.05), 3 months and 6 months after treatment, differences between the two groups were statistically significant(P<0.05). Conclusions Hydrodistension combined with intravesical instillation of hyaluronic acid or heparin cocktail method can effectively alleviate the symptoms of patients with IC/BPS; hyaluronic acid is superior to heparin cocktail method in the long-term efficacy.
Key words
interstitial cystitis/bladder pain syndrome /
hydrodistension /
intravesical instillation
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References
[1] Giannantoni A, Bini V, Dmochowski R, et al. Contemporary management of the painful bladder: a systematic review[J].Eur Urol,2012,61(1):29-53.
[2] Gillenwater J Y, Wein A J.Summary of the National Institute of Arthritis, Diabetes, Digestive and Kidney Diseases Workshop on Interstitial Cystitis, National Institutes of Health, Bethesda, Maryland, August 28-29,1987[J].J Urol,1988,140(1):203-206.
[3] 严秋哲,杨 勇,朱绪辉,等. 麻醉下水扩张诊断间质性膀胱炎[J].中华泌尿外科杂志,2007, 28(11):756-758.
[4] Nordling J, Anjum F H, Bade J J, et al. Primary evaluation of patients suspected of having interstitial cystitis (IC)[J]. Eur Urol, 2004,45(5):662-669.
[5] Bumpus H J.Interstitial cystitis: its treatment by overdistention of the bladder[J].Med Clin North Am,1930,13:1495-1498.
[6] Tomoe H, Kobayashi H, Nakazawa H, et al. The efficacy of hydro-distention of the bladder for interstitial cystitis[J]. J Interst Cyst,2004,2(11):24-31.
[7] Glemain P, Riviere C, Lenormand L, et al. Prolonged hydrodistention of the bladder for symptomatic treatment of interstitial cystitis: efficacy at 6 months and 1 year[J]. Eur Urol, 2002,41(1):79-84.
[8] Yamada T, Murayama T, Andoh M. Adjuvant hydrodistension under epidural anesthesia for interstitial cystitis[J].Int J Urol,2003,10(9):463-468.
[9] Hsieh C H, Chang W C, Huang M C, et al.Hydrodistention plus bladder training versus hydrodistention for the treatment of interstitial cystitis[J].Taiwan J Obstet Gynecol, 2012,51(4):591-595.
[10] Chai T C, Zhang C O, Shoenfelt J L, et al. Bladder stretch alters urinary heparin-binding epidermal growth factor and antiproliferative factor in patients with interstitial cystitis[J]. J Urol, 2000,163(5):1440-1444.
[11] Parsons C L,Bautista S L,Stein P C,et al. Cyto-injury factors in urine: a possible mechanism for the development of interstitial cystitis[J].J Urol, 2000,164(4):1381-1384.
[12] Kuo H C. Urodynamic results of intravesical heparin therapy for women with frequency urgency syndrome and interstitial cystitis[J]. J Formos Med Assoc, 2001,100(5):309-314.
[13] Asklin B, Cassuto J.Intravesical lidocaine in severe interstitial cystitis. Case report[J].Scand J Urol Nephrol,1989,23(4):311-312.[14] Nickel J C, Moldwin R, Lee S, et al. Intravesical alkalinized lidocaine (PSD597) offers sustained relief from symptoms of interstitial cystitis and painful bladder syndrome[J]. BJU Int,2009,103(7):910-918.
[15] Taneja R.Intravesical lignocaine in the diagnosis of bladder pain syndrome[J].Int Urogynecol J,2010,21(3):321-324.
[16] Riedl C R, Engelhardt P F, Daha K L,et al.Hyaluronan treatment of interstitial cystitis/painful bladder syndrome[J].Int Urogynecol J Pelvic Floor Dysfunct,2008,19(5):717-721.
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