[Intravesical instillations for inflammatory and sensory chronic bladder diseases: Literature review and guide to clinical practice].

Abstract

INTRODUCTION:

Inflammatory and sensory chronic bladder diseases have a significant impact on quality of life. These pathologies share alteration of the layer between urine and urothelium, making the use of topical agents appropriate.

OBJECTIVES:

Review the efficacy and tolerance of intravesical treatments for these pathologies. Give practical guidelines for the use of agents currently available in France.

METHOD:

A narrative review was performed in March 2021 using PubMed/MEDLINE, Google Scholar and the international guidelines. Pharmaceutical companies and pharmacies were interviewed.

RESULTS:

Although numerous molecules were tested over the last 5 decades, only dimethylsulfoxyde and glycosaminoglycans are available in France today. Results are promising: response rates are up to 95% and 84% respectively in bladder pain syndrome. In urinary tract infections, glycosaminoglycans could decrease annual number of cystitis by 2.56 (95% confidence interval (CI) -3.86, -1.26; P<0.001) and increase the time to first cystitis recurrence by 130 days (95% CI: 5.84 - 254.26; P=0.04). In radiation cystitis, results could be comparable to hyperbaric oxygen regarding pain and frequency of voiding (-1.31±1.3 visual analogic scale et -1.5±1.4 voiding per day, respectively, at 12 months, P<0.01). However, literature has a low level of evidence.

CONCLUSION:

Chronic bladder diseases have limited treatment options. Intravesical agents are a good alternative, although their cost is significant and their outcome uncertain.

• Authors: F Meyer, É Chen, N Berrogain, P O Bosset, S Campagne-Loiseau, V Cardot, T Charles, X Deffieux, L Donon, L Even, F Girard, J-F Hermieu, S Hurel, J Klap, L Peyrat, C Thuillier, B Tibi, A Vidart, L Wagner, J-N Cornu
• Journal: Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie (Prog Urol) Vol. 32 Issue 5 Pg. 388-399 (Apr 2022) ISSN: 1166-7087 [Print] France
• Vernacular Title: Instillations endovésicales pour les cystopathies chroniques inflammatoires et douloureuses : revue de la littérature et guide de la pratique clinique.
• PMID: 35125316 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2022 Elsevier Masson SAS. All rights reserved.

Chemical References

• Glycosaminoglycans

Topics

• Administration, Intravesical
• Chronic Disease
• Cystitis (drug therapy)
• Cystitis, Interstitial (drug therapy)
• Female
• Glycosaminoglycans (therapeutic use)
• Humans
• Male
• Quality of Life