Efficacy of intradetrusor platelet-rich plasma injection in treatment of interstitial cystitis

Medvedev V1, Lepetunov S1, Manuilov V1, Kogan M2, Medvedev A1

Research Type

Clinical

Abstract Category

Pelvic Pain Syndromes

Abstract 100
Pelvic Pain and Inflammation
Scientific Podium Short Oral Session 13
Thursday 28th September 2023
09:07 - 09:15
Theatre 102
Cell Culture Pain, Pelvic/Perineal Painful Bladder Syndrome/Interstitial Cystitis (IC) Urgency/Frequency Nocturia
1. Kuban State Medical University, Krasnodar, 2. Rostov State Medical University, Rostov-on-Don.
Presenter
Links

Abstract

Hypothesis / aims of study
The therapy of moderate and severe symptoms of interstitial cystitis (IC) recommended in the EU guidelines is not as effective. Intravesical administration of platelet-rich plasma (PRP) can improve the results of treatment of interstitial cystitis.
Study design, materials and methods
A single-center controlled randomized prospective trial that includes 85 women from 20 to 79 years old and with disease duration of 4.8±2.1 years. They were divided into 2 groups: 1 – 35 patients were treated with total of 5 procedures of cystoscopy with hydrodistension, each once in 2 weeks, 2 - 50 patients were treated with total of 5 intradetrusor PRP- injection into 20-22 points, each procedure was made once in 2 weeks (mean platelet concentration was 982х103/l). We assessed pain (VAS-scale), urgency and frequency (PUF-scale, IUS-scale), bladder diary, Global Response Assessment (GRA), bladder diary and bladder capacity before treatment,  after 1 and 12 months. Statistical analysis was made with Statistica 11.0 Software
Results
All measurements are presented in table 1: 
Table 1. Evaluation of symptoms, bladder capacity and other signs before and after treatment

Symptoms and signs                                Before treatment                                                      After treatment
	                                                              I group/II group	                                    I group (n=35)	              II group (n=50)
		                                                                                                                              1m	   12m	                 1m	       12m.
VAS-scale, score                                           7,3*/7,6**	                                              3,7*	    6,0*	                 3,3**      3,5**
Frequency, number	                                 20*/21**	                                              13,9*	    16,0*	                 14,0**    12,2**
Daytime urination, number	                         16,8*/18**	                                              10,5*	    13,2*	                 11*	         10*
Night urination, number	                         3,2*/3**                                                       3,4*	     2,8*	                 3*	         2,2**
Urgency, score	                                         2,5*/2,6**	                                              1,6*	     2,0*	                 1,9**	1,6**
Bladder capacity, ml	                                 201,7*/178,2**	                                      302,3*   313,7*	         332,0**	347,5**
PUF scale, total score                          	 27,4*/24,6**                                               17,6*      22,9*	                 15,9**	13,7**
PUF scale, symptoms, score	                 18,1*/15,8**	                                               11,1*     14,5*	                  11,9**	9,5**
PUF scale  bothersomeness, score	         9,3*/8,8**	                                                6,5*	      8,4*	                  6,3**	4,3**
GRA, score	                                                     0/0	                                                        3,5*	       1,8*	                  4,3**	3,8**
Hunners lession, %	                                 100/100	                                                 –	       74,6	                     –	28,0
Notes: 
*   р<0,05 (Wilcoxon rank test)
** р<0,05 (Wilcoxon rank test)
Interpretation of results
PRP therapy has shown positive results of reducing the clinical picture in comparison with standard therapy. The introduction of platelet-rich plasma has a beneficial effect on the bladder mucosa, reducing the risk of Hunner's ulcers.
Concluding message
Standard therapy of IC leads to a significant decrease in the manifestations of the disease after 1 months. The same results have been demonstrated in PRP-group. However, there was worsening of symptoms in the 1st group after 12 months (but they don’t reach the initial values).  On the other hand, there were a stable pain symptoms by 12th month in the 2d group and improvement of other signs and symptoms (p<0,05) compared to initial values and 1 month after PRP – injection.
Disclosures
Funding government funding (aspirnantura) Clinical Trial Yes Public Registry No RCT Yes Subjects Human Ethics Committee Ethics Committee Rostov State Medical University Helsinki Yes Informed Consent Yes
Citation

Continence 7S1 (2023) 100818
DOI: 10.1016/j.cont.2023.100818

01/11/2024 12:08:32