Clinical Observation On Intravesical Instillation Of Sodium Hyaluronate For Treatment Of Non-bacterial Cystitis

ObjectiveTo observe the clinical efficacy and safety on intravesical instillation of sodium hyaluronate for treatment of non-bacterial cystitis, and compare the efficacy that sodium hyaluronate treated iatrogenic cystitis with non-iatrogenic cystitis.Materials and Methods1. Totally28patients with non-bacterial cystitis were included, the diagnosis is according to clinical symptoms and cystoscopy,there were9cases of chemical cystitis, which were instillation with mitomycin C and pirarubicin after TURBt;4cases of radioactive cystitis, which were received radiotherapy for cervical cancer or rectal cancer; and also6cases of interstitial cystitis. All cases were32-58years old, the courses were from3months to5years, there were21cases (75%) that the course is more than1year. Clinical manifestation were urinary frequency, urgency, urinary bladder pain,12patients were with perineal and (or) urinary tract pain, relieved after urination. Routine urine, urine bacteria culture, routine blood, liver and kidney function were normal.They received intravesical instillation(sodium hyaluronate solution of50ml/40mg) once a week for4weeks.then once every two weeks for the next4weeks and at last once a month for the next2months.The follow-up visited was performed once every two weeks,ended at the16th week.Evaluate the efficacy and safety of the sodium hyaluronate according to patients’symptom assessment VAS scores and the micturition diary2. Classified28patients into iatrogenic cystitis and non-iatrogenic cystitis. Futher discussed the pathogenesis and treatment of two kinds of cystitis, through observing those total effective rate for sodium hyaluronate treatment.Results1.28patients all completed the instillation and follow-up. At the4th week,the VAS score of pain dropped from6.86±1.74to5.93±1.412(p＜O.001); the VAS score of urgency dropped from8.18±1.124to6.75±0.967(P＜O.001);void per day dropped from12.82±2.681to11.82±2.681(P＜O.001);and the mean BC(bladder capacity) rose from106.71±22.65to125.96±22.769(P<0.001).At the16th week,the VAS score of pain a dropped from6.86±1.74to2.71±0.897(p<0.001); the VAS score of urgency dropped from8.18±1.124to2.18±0.772(P<0.001);void per day dropped from12.82±2.681to9.11±1.343(P<0.001);and the mean BC(bladder capacity) rose from106.71±22.65to163.93±32.00(P<0.001), The difference were significative.2. The total effective rate of iatrogenic cystitis (vs non-iatrogenic cystitis) at4th,8th,12th,16th week was53.8%(20.0%),61.5%(26.7%),76.9%(33.3%),84.6%(40.0%), respectively.The difference were significative at12th,16th week (p<0.05).Conclusions1. The short-term curative effect and safety of intravesical irrigation to treat the non-bacterial cystitis is worth affirmation.It can significantly relieve symptoms.and improve the quality of life.2. We guess that for iatrogenic cystitis from chemotherapy or radiotherapy, intravesical instillation of sodium hyaluronate can markedly delay or even prevent the development of the inflammatory processes,It can make patients receive chemotherapy or radiotherapy renewedly.