IMR Press / CEOG / Volume 45 / Issue 2 / DOI: 10.12891/ceog4571.2018

Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on as a courtesy and upon agreement with S.O.G.

Original Research
Long-term efficacy of intravesical instillation of hyaluronic acid/chondroitin sulfate in recurrent bacterial cystitis: 36 months' follow-up
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1 Chronic Pelvic Pain Centre, Dep. of Obstetrics and Gynaecology, Ospedale S. Maria Della Speranza, Battipaglia, Italy
2 Institute of Urology, University of Sassari, Sassari, Italy
3 Ostetricia e Ginecologia, ASL Napoli 2 Nord, Naples, Italy
4 Gynecologic and Obstetric Clinic, Dep. of Surgical, Microsurgical and Medical Sciences, University of Sassari, Italy
5 Division of Plastic Surgery, Department of Surgery, Turku University Hospital, OS Turku, Finland

† These authors contributed equally.

Clin. Exp. Obstet. Gynecol. 2018, 45(2), 224–228;
Published: 10 April 2018

Purpose of Investigation: To compare the efficacy and safety of intravesical instillation of hyaluronic acid/chondroitin sulfate with conventional long-term antibiotic prophylaxis in women with recurrent bacterial cystitis. Materials and Methods: In this analysis of a prospective study, where women with recurrent bacterial cystitis were randomised to intravesical hyaluronic acid 800 mg/chondroitin sulfate 1,000 mg (group 1) or long-term antibiotic prophylaxis (group 2 – control group), patients in group 1 were evaluated 36 months after treatment. Outcomes included cystitis recurrence, subjective pain symptoms based on a visual analogue scale (VAS), three-day voiding, pelvic pain and urgency/frequency symptoms (PUF scale), sexual function questionnaire, quality of life based on King’s Health Questionnaire (KHQ), maximum cystometric capacity (MCC), and adverse events. Results: Twelve women (mean ± standard deviation 59.3 ± 13.9 years old) underwent follow-up at 36 months after treatment. There were improvements in all efficacy evaluations at 36 months’ follow-up, with significantly favourable mean changes from baseline in cystitis frequency (–5.4 episodes/year; p < 0.001), three-day voiding (–10.7 voids; p = 0.002), urinary VAS (–6.7 points; p < 0.001), PUF (–14.2 points; p < 0.001), sexual function (–4.3 points; p < 0.001) and KHQ (–34.0; p < 0.001) scores, and MCC (+131.7; p < 0.001). No adverse events were reported. Conclusions: Intravesical hyaluronic acid/chondroitin sulfate significantly reduced cystitis recurrence and associated symptoms and was well tolerated in women with recurrent bacterial cystitis at 36 months’ after treatment.
Chondroitin sulfate
Hyaluronic acid
Intravesical instillation
Recurrent bacterial cystitis
Recurrent urinary tract infection
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