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Sodium hyaluronate and chondroitin sulfate replenishment therapy can improve nocturia in men with post-radiation cystitis: results of a prospective pilot study.

Gacci M, Saleh O, Giannessi C, Detti B, Livi L, Monteleone Pasquetti E, Masoni T, Finazzi Agro E, Li Marzi V, Minervini A, Carini M, Gravas S, Oelke M, Serni S - BMC Urol (2015)

Bottom Line: With logistic regression analysis, both age and baseline ICSI-Q3 had a significant impact on nocturnal voiding frequency (r = 0.293, p = 0.011 and r = 0.970, p < 0.001).Pre- and post-treatment ICPI-Q2 was 1.87 ± 0.26 and 1.30 ± 0.25 (-30.5%, p = 0.016); logistic regression analysis was without significant findings.Bladder instillation treatment with a combination of HA and CS was effective in reducing nocturnal voiding frequency in men with post-radiation bladder pain for PCa.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, University of Florence, Careggi Hospital, Largo Brambilla 3, Urologic Clinic San Luca, Florence, 50100, Italy. maurogacci@yahoo.it.

ABSTRACT

Background: Radiotherapy is one of the treatment options for prostate cancer (PCa) but up to 25% of men report about severe nocturia (nocturnal voiding). The combination of hyaluronic acid (HA) and chondroitin sulfate (CS) resembles glycosaminoglycan (GAG) replenishment therapy. The aim of our study was to evaluate the impact of HA and CS on nocturia, in men with nocturia after PCa radiotherapy.

Methods: Twenty-three consecutive patients with symptomatic cystitis after external radiotherapy for PCa were enrolled. Patients underwent bladder instillation therapy with HA and CS weekly for the first month and, afterwards, on week 6, 8 and 12. Nocturnal voiding frequency was assessed by item 3 (Q3) of the Interstitial Cystitis Symptoms Index (ICSI) and item 2 (Q2) of the Interstitial Cystitis Problem Index (ICPI). Data were analyzed with paired-samples T-test and adjusted for age.

Results: Eighteen patients (78%) reported about nocturia. Pre- and post-treatment ICSI-Q3 was 2.13 ± 0.28 and 1.61 ± 0.21 (-24.4%, p = 0.001). With logistic regression analysis, both age and baseline ICSI-Q3 had a significant impact on nocturnal voiding frequency (r = 0.293, p = 0.011 and r = 0.970, p < 0.001). Pre- and post-treatment ICPI-Q2 was 1.87 ± 0.26 and 1.30 ± 0.25 (-30.5%, p = 0.016); logistic regression analysis was without significant findings.

Conclusion: Bladder instillation treatment with a combination of HA and CS was effective in reducing nocturnal voiding frequency in men with post-radiation bladder pain for PCa. Randomized, controlled trials with sham treatment are needed to confirm our result.

No MeSH data available.


Related in: MedlinePlus

Pre and post treatment mean value of ICSI-Q3 (a), ICPI-Q2 (b), ICSI Total score (c) and ICPI Total score (d). Bars represent 95 % confidence intervals. The relative adjusted and level of significance (p) are reported in the text
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Fig1: Pre and post treatment mean value of ICSI-Q3 (a), ICPI-Q2 (b), ICSI Total score (c) and ICPI Total score (d). Bars represent 95 % confidence intervals. The relative adjusted and level of significance (p) are reported in the text

Mentions: Men with nocturnal voiding presented a statistically significant recovery of this symptom, after treatment with HA and CS (Table 1). In particular, there was a significant reduction of ICSI/ICPI total score and ICSI-Q3 and ICPI-Q2 between pre-treatment baseline and post-treatment evaluation (Fig. 1 and Table 2). Specifically regarding symptoms (ICSI Q3), 10 patients (56 %) showed improvement in the number of nocturnal voids, 8 patients (44 %) had no change and no patient reported worsening. Regarding bother (ICPI Q2), 10 patients (56 %) showed improvement, 7 patients (39 %) had no change, and only 1 patient reported worsening. At the end of bladder instillation treatment, men without nocturia at baseline continued to be without nocturia: therefore, these 5 men were excluded by further statistical analyses (Table 3).Table 1


Sodium hyaluronate and chondroitin sulfate replenishment therapy can improve nocturia in men with post-radiation cystitis: results of a prospective pilot study.

Gacci M, Saleh O, Giannessi C, Detti B, Livi L, Monteleone Pasquetti E, Masoni T, Finazzi Agro E, Li Marzi V, Minervini A, Carini M, Gravas S, Oelke M, Serni S - BMC Urol (2015)

Pre and post treatment mean value of ICSI-Q3 (a), ICPI-Q2 (b), ICSI Total score (c) and ICPI Total score (d). Bars represent 95 % confidence intervals. The relative adjusted and level of significance (p) are reported in the text
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4493946&req=5

Fig1: Pre and post treatment mean value of ICSI-Q3 (a), ICPI-Q2 (b), ICSI Total score (c) and ICPI Total score (d). Bars represent 95 % confidence intervals. The relative adjusted and level of significance (p) are reported in the text
Mentions: Men with nocturnal voiding presented a statistically significant recovery of this symptom, after treatment with HA and CS (Table 1). In particular, there was a significant reduction of ICSI/ICPI total score and ICSI-Q3 and ICPI-Q2 between pre-treatment baseline and post-treatment evaluation (Fig. 1 and Table 2). Specifically regarding symptoms (ICSI Q3), 10 patients (56 %) showed improvement in the number of nocturnal voids, 8 patients (44 %) had no change and no patient reported worsening. Regarding bother (ICPI Q2), 10 patients (56 %) showed improvement, 7 patients (39 %) had no change, and only 1 patient reported worsening. At the end of bladder instillation treatment, men without nocturia at baseline continued to be without nocturia: therefore, these 5 men were excluded by further statistical analyses (Table 3).Table 1

Bottom Line: With logistic regression analysis, both age and baseline ICSI-Q3 had a significant impact on nocturnal voiding frequency (r = 0.293, p = 0.011 and r = 0.970, p < 0.001).Pre- and post-treatment ICPI-Q2 was 1.87 ± 0.26 and 1.30 ± 0.25 (-30.5%, p = 0.016); logistic regression analysis was without significant findings.Bladder instillation treatment with a combination of HA and CS was effective in reducing nocturnal voiding frequency in men with post-radiation bladder pain for PCa.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, University of Florence, Careggi Hospital, Largo Brambilla 3, Urologic Clinic San Luca, Florence, 50100, Italy. maurogacci@yahoo.it.

ABSTRACT

Background: Radiotherapy is one of the treatment options for prostate cancer (PCa) but up to 25% of men report about severe nocturia (nocturnal voiding). The combination of hyaluronic acid (HA) and chondroitin sulfate (CS) resembles glycosaminoglycan (GAG) replenishment therapy. The aim of our study was to evaluate the impact of HA and CS on nocturia, in men with nocturia after PCa radiotherapy.

Methods: Twenty-three consecutive patients with symptomatic cystitis after external radiotherapy for PCa were enrolled. Patients underwent bladder instillation therapy with HA and CS weekly for the first month and, afterwards, on week 6, 8 and 12. Nocturnal voiding frequency was assessed by item 3 (Q3) of the Interstitial Cystitis Symptoms Index (ICSI) and item 2 (Q2) of the Interstitial Cystitis Problem Index (ICPI). Data were analyzed with paired-samples T-test and adjusted for age.

Results: Eighteen patients (78%) reported about nocturia. Pre- and post-treatment ICSI-Q3 was 2.13 ± 0.28 and 1.61 ± 0.21 (-24.4%, p = 0.001). With logistic regression analysis, both age and baseline ICSI-Q3 had a significant impact on nocturnal voiding frequency (r = 0.293, p = 0.011 and r = 0.970, p < 0.001). Pre- and post-treatment ICPI-Q2 was 1.87 ± 0.26 and 1.30 ± 0.25 (-30.5%, p = 0.016); logistic regression analysis was without significant findings.

Conclusion: Bladder instillation treatment with a combination of HA and CS was effective in reducing nocturnal voiding frequency in men with post-radiation bladder pain for PCa. Randomized, controlled trials with sham treatment are needed to confirm our result.

No MeSH data available.


Related in: MedlinePlus