Urinary and psychological outcomes in women with interstitial cystitis/bladder pain syndrome following hyaluronic acid treatment

Abstract Objective To investigate urinary and psychological symptoms in patients with interstitial cystitis/bladder pain syndrome (IC/BPS) after intravesical hyaluronic acid (HA) treatment. Materials and methods Thirty patients with newly diagnosed with IC/BPS undergoing 4 weekly intravesical HA instillations followed by 5 monthly instillations were recruited. Pre-treatment evaluation included a urinalysis and urinary culture, a 3-day voiding diary, and cystoscopy with hydrodistention of the bladder. Questionnaires containing hospital anxiety and depression scale (HADS), O'Leary-Sant score, Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ-12), and a pain visual analog scale were completed before and after treatment. Thirty age-matched, asymptomatic women were recruited as controls for assessing HADS scores, and comparison of urinary and psychological symptoms in patients before and after HA treatment. Results The mean age (range 25–71 years old) and symptomatic duration (range 1–11 years) were 47 and 4.5, respectively. When compared with the control group, patients with IC/BPS had a significant increase in HADS depression subscale score and total score. Frequency, nocturia, bladder capacity, IC symptom and problem index scores, and pain score improved after 6 months of intravesical HA treatment. After HA treatment, 73% (n = 22) of patients showed improvement in their urological symptoms, but no significant changes were found in their HADS and PISQ-12 scores. Conclusions Bladder pain and lower urinary tract symptoms in patients with IC/BPS may improve after a 6-month intravesical HA treatment. However, no significant changes in their psychological and sexual functional scores were found.