Abstract

Background: Bladder pain syndrome (BPS), also known as interstitial cystitis (IC), is a systemic pain, usually originating from pain in the bladder, then spreading to the pelvis. It is characterized by inflammation that partially or completely destroys the mucosal layer and may extend into the Detrusormuscle layer; However, the etiology and pathogenesis of this disease remain enigmatic. In the treatment of interstitial cystitis, Dimethylsulfoxide (DMSO) is the most commonly used agent for bladder pump in the treatment of painful BPS/IC. Which is also a widely accepted method in the EAU and AUA Guideline. Currently, there have been many studies showing that a mixture of hyaluronic acid and chondroitin sulphate is equally effective in treating interstitial cystitis.

Methods: This is a prospective study describing a series of clinical cases, conducted from March 2020 to January 2022 on 26 patients. We use a blend of hyaluronic acid and chondroitin sulphate (iAluRil® Prefill) to inflate the bladder for 1 treatment session (10 injections). The outcome was then assessed at 1, 3 and 6 months after the intervention, the patients were evaluated based on the overactive bladder score (OAB - Q), IC O’Leary - Sant questionnaire (ICSI) and pain assessment table (VAS). We also compared the bladder pump group with hyaluronic acid and chondroitin sulphate (A, n = 26.) with the group treated with pelvic floor muscle contraction alone (B, n = 38). We use ANNOVA test, Fisher test and SPSS 22 software.

Results: All parameters improved after in both groups A and B, but the effectiveness of the hyaluronic acid and chondroitin sulphate (A) mixed bladder pump group improved significantly with ICSI, OAB - Q and VAS scores were lower in group A. Furthermore, the difference significantly increased over time at followup. This is a method of high potential when compared with many other medical treatments, with high efficiency, reasonable cost as well as few complications. Pelvic floor muscle contraction exercises with pelvic floor muscle machines are only effective in patients with minimal symptoms and good exercise adherence.

Conclusions: Mixed bladder pump therapy of hyaluronic acid and chondroitin sulphate showed effective symptom improvement in IC/BPS as well as reduced frequency and pain for patients.