Intravesical treatment with highly-concentrated hyaluronic acid and chondroitin sulphate in patients with recurrent urinary tract infections: Results from a multicentre survey

Antonio Cicione, Francesco Cantiello, Giuseppe Ucciero, Andrea Salonia, Marco Torella, Marco De Sio, Riccardo Autorino, Antonio Carbone, Martin Romancik, Roman Tomaskin, Rocco Damiano

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Abstract

Introduction: We assess the effectiveness of intravesical instillation of hyaluronic acid (HA) and chondroitin sulphate (CS) as a non-antibiotic treatment option for prophylaxis of recurrent urinary tract infections (UTIs) in female patients.

Methods: This was a retrospective cohort study involving 7 European institutions. We included patients with recurrent UTIs who received intravesical instillations of Ialuril (IBSA International) (50 mL HA 1.6% and CS 2% solution) between January 2010 and March 2012. Medication schedule, length of follow-up, recurrence infection time, number of UTIs/patients/year, patient quality of life, subjective symptoms score, and treatment-emergent side effects were recorded and analyzed.

Results: In total, 157 women (mean age: 54.2 ± 4.1 years) were included in the analysis. All patients had at least 12 months followup. After 4 weekly and 5 monthly HA-CS bladder instillations, UTI episodes decreased from 4.13 ± 1.14 to 0.44 ± 0.50 (p = 0.01) at 12 months, while recurrent UTI time prolonged from 94.8 ± 25.1 days to 178.4 ± 37.3 days (p = 0.01) at 12 months. An improvement in symptoms and quality of life was achieved. A medium-depth pain after medication instillation was the most reported side effect. Regression model analysis showed significant risk factors in developing new UTI episodes: being more than 50 years old and having more than 4 UTI episodes per year (OR 3.41; CI 95%; 1.51-7.71, p = 0.003 and OR 3.31; CI 95% 1.51-7.22; p = 0.003, respectively). Retrospective design and lack of a control group represent two main limitations of the study.

Conclusions: Restoring glycosaminoglycans bladder layer therapy is a promising non-antibiotic therapy to prevent recurrent UTIs.

Original languageEnglish
Pages (from-to)E721-E727
JournalJournal of the Canadian Urological Association
Volume8
Issue number9-10 OCTOBER
DOIs
Publication statusPublished - Oct 1 2014

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Chondroitin Sulfates
Hyaluronic Acid
Urinary Tract Infections
Intravesical Administration
Therapeutics
Quality of Life
Surveys and Questionnaires
Glycosaminoglycans
Appointments and Schedules
Urinary Bladder
Cohort Studies
Retrospective Studies
Regression Analysis
Recurrence
Pain
Control Groups
Infection

ASJC Scopus subject areas

  • Oncology
  • Urology

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Intravesical treatment with highly-concentrated hyaluronic acid and chondroitin sulphate in patients with recurrent urinary tract infections : Results from a multicentre survey. / Cicione, Antonio; Cantiello, Francesco; Ucciero, Giuseppe; Salonia, Andrea; Torella, Marco; De Sio, Marco; Autorino, Riccardo; Carbone, Antonio; Romancik, Martin; Tomaskin, Roman; Damiano, Rocco.

In: Journal of the Canadian Urological Association, Vol. 8, No. 9-10 OCTOBER, 01.10.2014, p. E721-E727.

Research output: Contribution to journalArticle

Cicione, Antonio ; Cantiello, Francesco ; Ucciero, Giuseppe ; Salonia, Andrea ; Torella, Marco ; De Sio, Marco ; Autorino, Riccardo ; Carbone, Antonio ; Romancik, Martin ; Tomaskin, Roman ; Damiano, Rocco. / Intravesical treatment with highly-concentrated hyaluronic acid and chondroitin sulphate in patients with recurrent urinary tract infections : Results from a multicentre survey. In: Journal of the Canadian Urological Association. 2014 ; Vol. 8, No. 9-10 OCTOBER. pp. E721-E727.
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abstract = "Introduction: We assess the effectiveness of intravesical instillation of hyaluronic acid (HA) and chondroitin sulphate (CS) as a non-antibiotic treatment option for prophylaxis of recurrent urinary tract infections (UTIs) in female patients.Methods: This was a retrospective cohort study involving 7 European institutions. We included patients with recurrent UTIs who received intravesical instillations of Ialuril (IBSA International) (50 mL HA 1.6{\%} and CS 2{\%} solution) between January 2010 and March 2012. Medication schedule, length of follow-up, recurrence infection time, number of UTIs/patients/year, patient quality of life, subjective symptoms score, and treatment-emergent side effects were recorded and analyzed.Results: In total, 157 women (mean age: 54.2 ± 4.1 years) were included in the analysis. All patients had at least 12 months followup. After 4 weekly and 5 monthly HA-CS bladder instillations, UTI episodes decreased from 4.13 ± 1.14 to 0.44 ± 0.50 (p = 0.01) at 12 months, while recurrent UTI time prolonged from 94.8 ± 25.1 days to 178.4 ± 37.3 days (p = 0.01) at 12 months. An improvement in symptoms and quality of life was achieved. A medium-depth pain after medication instillation was the most reported side effect. Regression model analysis showed significant risk factors in developing new UTI episodes: being more than 50 years old and having more than 4 UTI episodes per year (OR 3.41; CI 95{\%}; 1.51-7.71, p = 0.003 and OR 3.31; CI 95{\%} 1.51-7.22; p = 0.003, respectively). Retrospective design and lack of a control group represent two main limitations of the study.Conclusions: Restoring glycosaminoglycans bladder layer therapy is a promising non-antibiotic therapy to prevent recurrent UTIs.",
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AU - Cicione, Antonio

AU - Cantiello, Francesco

AU - Ucciero, Giuseppe

AU - Salonia, Andrea

AU - Torella, Marco

AU - De Sio, Marco

AU - Autorino, Riccardo

AU - Carbone, Antonio

AU - Romancik, Martin

AU - Tomaskin, Roman

AU - Damiano, Rocco

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N2 - Introduction: We assess the effectiveness of intravesical instillation of hyaluronic acid (HA) and chondroitin sulphate (CS) as a non-antibiotic treatment option for prophylaxis of recurrent urinary tract infections (UTIs) in female patients.Methods: This was a retrospective cohort study involving 7 European institutions. We included patients with recurrent UTIs who received intravesical instillations of Ialuril (IBSA International) (50 mL HA 1.6% and CS 2% solution) between January 2010 and March 2012. Medication schedule, length of follow-up, recurrence infection time, number of UTIs/patients/year, patient quality of life, subjective symptoms score, and treatment-emergent side effects were recorded and analyzed.Results: In total, 157 women (mean age: 54.2 ± 4.1 years) were included in the analysis. All patients had at least 12 months followup. After 4 weekly and 5 monthly HA-CS bladder instillations, UTI episodes decreased from 4.13 ± 1.14 to 0.44 ± 0.50 (p = 0.01) at 12 months, while recurrent UTI time prolonged from 94.8 ± 25.1 days to 178.4 ± 37.3 days (p = 0.01) at 12 months. An improvement in symptoms and quality of life was achieved. A medium-depth pain after medication instillation was the most reported side effect. Regression model analysis showed significant risk factors in developing new UTI episodes: being more than 50 years old and having more than 4 UTI episodes per year (OR 3.41; CI 95%; 1.51-7.71, p = 0.003 and OR 3.31; CI 95% 1.51-7.22; p = 0.003, respectively). Retrospective design and lack of a control group represent two main limitations of the study.Conclusions: Restoring glycosaminoglycans bladder layer therapy is a promising non-antibiotic therapy to prevent recurrent UTIs.

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