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  • Title: Do cystometric findings predict the results of intravesical hyaluronic acid in women with interstitial cystitis?
    Author: Daha LK, Riedl CR, Lazar D, Hohlbrugger G, Pflüger H.
    Journal: Eur Urol; 2005 Mar; 47(3):393-7; discussion 397. PubMed ID: 15716206.
    Abstract:
    INTRODUCTION AND OBJECTIVES: According to National Institute of Health (NIH) criteria, a bladder capacity of less than 350 cc is an automatic exclusion for a diagnosis of Interstitial Cystitis (IC). In the present study, patients, showing symptoms of IC and with bladder capacities of <350 and >/=350 cc were tested as to their response to a intravesical hyaluronic acid therapy. METHODS: The study included 48 patients with clinical symptoms of IC and a positive 0.4 M potassium sensitivity test. Maximum bladder capacity (C(max)) was assessed for the 0.9% NaCl solution first and then for the 0.2 M KCl solution. After the NaCl cystometry, patients were separated into two groups: Group I with a C(max) of <350 cc and Group II with a C(max) of >/=350 cc. Both groups were again separated in two further groups as to the respective percentage reduction of C(max) with the 0.2 M KCl solution: Group Ia/IIa (>/=30%) and Group Ib/IIb (<30%). Patients were treated with weekly instillations of 40 mg hyaluronic acid for 10 consecutive weeks. Pre- and post-treatment bladder symptoms were evaluated through their visual analog scale (VAS) scores. RESULTS: With the saline solution, 32 patients had a C(max) of <350 cc (Group I), while 16 patients had a C(max) of >/=350 cc (Group II). Evaluation of VAS scores confirmed a positive response, i.e. symptom relief, to hyaluronic acid therapy, irrespective of bladder capacity. The improvement was particularly evident in patients with a C(max) reduction of >/=30% versus those with a reduction of <30% with the 0.2 M KCl solution (p=0.003). CONCLUSION: The present study demonstrates that patients with typical IC symptoms and a cystometric bladder capacity of >/=350 cc, may have increased potassium sensitivity as a sign of IC and show symptom improvement after hyaluronic acid instillation therapy.
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