Managing chronic bladder diseases with the administration of exogenous glycosaminoglycans: An update on the evidence

Massimo Lazzeri, Rodolfo Hurle, Paolo Casale, NicolòMaria Buffi, Giovanni Lughezzani, Girolamo Fiorini, Roberto Peschechera, Luisa Pasini, Silvia Zandegiacomo, Alessio Benetti, Gianluigi Taverna, Giorgio Guazzoni, Guido Barbagli

Research output: Contribution to journalArticle

Abstract

Although the pathophysiology of acute chronic cystitis and other 'sensory' disorders, i.e. painful bladder syndrome (PBS) or interstitial cystitis (IC), often remains multifactorial, there is a wide consensus that such clinical conditions may arise from a primary defective urothelium lining or from damaged glycosaminoglycans (GAGs). A 'cascade' of events starting from GAG injury, which fails to heal, may lead to chronic bladder epithelial damage and neurogenic inflammation. To restore the GAG layer is becoming the main aim of new therapies for the treatment of chronic cystitis and PBS/IC. Preliminary experiences with GAG replenishment for different pathological conditions involving the lower urinary tract have been reported. There is a range of commercially available intravesical formulations of these components, alone or in combination. Literature evidence shows that exogenous intravesical hyaluronic acid markedly reduces recurrences of urinary tract infections (UTIs). Patients treated with exogenous GAGs have fewer UTI recurrences, a longer time to recurrence and a greater improvement in quality of life. Exogenous intravesical GAGs have been used for the treatment of PBS/IC. Despite the limitations of most of the studies, findings confirmed the role of combination therapy with hyaluronic acid and chondroitin sulfate as a safe and effective option for the treatment of PBS/IC. To prevent and/or treat radiotherapy and chemotherapy induced cystitis, GAG replenishment therapy has been used showing preliminary encouraging results. The safety profile of exogenous GAGs has been reported to be very favourable, without adverse events of particular significance.

Original languageEnglish
Pages (from-to)91-99
Number of pages9
JournalTherapeutic Advances in Urology
Volume8
Issue number2
DOIs
Publication statusPublished - Apr 1 2016

Fingerprint

Urinary Bladder Diseases
Interstitial Cystitis
Glycosaminoglycans
Chronic Disease
Cystitis
Hyaluronic Acid
Recurrence
Urinary Tract Infections
Therapeutics
Sensation Disorders
Neurogenic Inflammation
Urothelium
Chondroitin Sulfates
Urinary Tract
Urinary Bladder
Radiotherapy
Quality of Life
Safety
Drug Therapy

Keywords

  • cystitis
  • glycosaminoglycans
  • therapy
  • urothelium

ASJC Scopus subject areas

  • Urology

Cite this

Managing chronic bladder diseases with the administration of exogenous glycosaminoglycans : An update on the evidence. / Lazzeri, Massimo; Hurle, Rodolfo; Casale, Paolo; Buffi, NicolòMaria; Lughezzani, Giovanni; Fiorini, Girolamo; Peschechera, Roberto; Pasini, Luisa; Zandegiacomo, Silvia; Benetti, Alessio; Taverna, Gianluigi; Guazzoni, Giorgio; Barbagli, Guido.

In: Therapeutic Advances in Urology, Vol. 8, No. 2, 01.04.2016, p. 91-99.

Research output: Contribution to journalArticle

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