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RESUMEN DE COMUNICACIÓN
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Intravesical instillation with hyaluronic acid and chondroitin sulfate treatment for chronic inflammatory diseases of the lower urinary tract.
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Guardiola Ruiz, I.; Server Gómez, G.; Valor Pérez, M.; García García, O.; Montoya Chinchilla, R.; Pardo Martínez, A.; García Espona, C.; Sala Lafuente, L.; Rodríguez Tardido, A.; Hita Rosino, E.; Moreno Avilés, J.; Cachay Ayala, M.
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Hospital Universitario Santa Lucía de Cartagena
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- Introduction. The bladder epithelium has a protective layer of glycosaminoglycans (GAG) formed by hyaluronic acid (HA) and chondroitin sulfate (CS), among other components. GAG deficiency is associated with chronic inflammatory diseases of the lower urinary tract (LUT), such as bladder pain syndrome (BPS), recurrent urinary tract infections (rUTI), radiation cystitis (RC), urethral pain syndrome (UOS) or overactive bladder (OAB). Intravesical instillations with HA-CS have been used for years as a treatment for these diseases, although the evidence is limited.
- Primary objective: To evaluate the efficacy of intravesical instillations with HA-CS as a treatment for these diseases. Secondary objectives: To assess overall clinical outcomes after treatment; to evaluate improvement and clinical outcomes after different treatment regimes; and to evaluate clinical improvement and clinical according to the treated pathology.
- Material and Method. This retrospective observational study included 59 patients who received intravesical instillations with HA-CS from 2018 to 2020. We analyzed urological disease, symptoms before and after treatment, improvement after treatment, side effects and treatment regimen. We performed a descriptive analysis of these variables.
- Results. The most frequent disease was rUTI (35.6%), followed by RC and BPS). The most frequent symptoms were urgency and UTI (45.8% both). 67.8% of the patients had a clinical improvement and the treatment significantly reduced symptoms, showing the greatest decrease in hematuria (76.9%). We observed significant improvement in 90% of the patients who received a complete cycle, as well as a decrease in symptomatology, especially hematuria (88.9%) and pain (70%). No significant differences were found in improvement stratified by disease.
- Conclusions. Intravesical instillation with HA-CS is effective in treating chronic inflammatory diseases of the LUT. It reduces the frequency of overall symptoms, produces a clinical improvement and obtains symptomatic relief in most of our patients. Conclusions cannot be drawn about clinical outcomes between the different diseases.
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