Effects of intravesical sodium hyaluronate on vesical mucosa in recurrent chronic
bacterial cystitis
Lianos E., Mountraski S., Zampiozis E.
Urology Department General Hospital Agios Nikolas. Crete. Greece
Purpose:
Aim of this study was to evaluate the effect of sodium hyaluronate on epithelial healing
of the bladder mucosa and vesical fibrosis induced by chronic recurrent bacterial
cystistat.
Patients and Methods
Twenty women aged 27 to 40 years old with a history of recurrent low urinary tract
infection (LUTS) received intravesical instillations of Hyaluronic Acid (HA) 40 mg once
weekly for 4 weeks, then once monthly for 4 months. Bladder biopsies was performed at
entry and fourth week of the trial to assess the effects on bladder mucosa and determine
the condition of the epithelial membrane and extension of fibrosis.
Exclusion criteria: Neurogenic bladder, urolithiasis, anatomical abnormalities, use of
indwelling catheters.
Results
Histological examination of the biopsy specimens before the first installation reveal
extensive damage and fibrosis of the mucosal epithelium in 15 patients and moderate
alternations in 5 more patients. After the four weeks of treatment repeated biopsies
revealed accelerated epithelial healing of the vesical mucosa and inhibited vesical fibrosis
in 14 patients (70%). Non relevant histological alterations in six patients. All patients
were recurrence-free at the end of the treatment. Side-effects were limited to four patients
who reported mild bladder irritation.
Conclusions
Our findings suggest that sodium hyaluronate is effective for promoting epithelial healing
of the vesical mucosa and inhibiting vesical fibrosis.
The article was presented at
23rd World Congress on Endourology and Swl 21st Basic Research Symposium; August
23–26, 2005; Amsterdam, The Netherlands. Journal of Endourology. Jul 2005, Vol. 19, No.
supplement 1: p1-p121