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Efficacy of sodium hyaluronate in the management of chemical and radiation cystitis Sommariva et al. Minerrva Urol Nefrol 2010. Indications Cystitis after radiotherapy for prostatic cancer

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Efficacy of sodiumhyaluronate in themanagement of chemical and radiationcystitisSommariva et al.

MinerrvaUrolNefrol 2010


Indications

  • Cystitisafterradiotherapyforprostaticcancer

  • Cystitis in patientsreceivinginmuno-chemotherapeuticagentsbyintravesicalinjstillationfor non-muscleinvasivetransitionalcell carcinoma of thebladder (BCG orMitomycin C)

    Poor and Slow response tothe usual symptomatictreatments

    Thesebladdersymptomsoften mean thatcancertherapy has tobeinterrupted, which has furtherclinicalimplications, liketheimpactonthepossibility of success


Administration of Cystistat

  • 69 maleconsecutivepatients

  • 15 afterRadiotherapy (Rxt)

  • 24 after BCG

  • 30afterMitomycin C


Administration of Cystistat

  • Cystistatwasadministeredweeklyfrom 8 to 24 weeks, dependingonhowthyesymptomsreleased.

  • Lidocaine 2% 30 mLwasinstilled 30 min before, toallowpatientstokeepCystistatwithinthebladder

  • In thefirst 4 weeks, Dexamethasone 32 mg wasmixedto HA lookingforanantiinflammatoryeffect


Results

  • – BladderCapacity (BC)

  • – Visual Analogic Score (VAS) forPain

  • Afteronly 4 weeks BC increased in allpatients, and Urgency and Painalmostdisappeared. Treatmentwascontinuedhoweverforanother 4 weeks, even in patientswith total remission of theirsymptoms.

  • Itwasseenpreviouslybytheauthorsthatiftherapystoppedtosoon, thenthesymptomscouldreturn.


ChemicalCystitisgroupRIC groupBTATBTAT

VAS 8,6 0,9 NotMeasured

  • (Frequency + Urgency)

  • BC BTATBTAT

  • 58,4 283,7 85,0243,3


  • 97% reported complete relief of dysuria and pain

  • No adversereactions, allowingtheconclusion of treatmentsforbladdercancer

  • Aftertherapy, urinarycitology and cistoscopyruledoutbledderrcancerprogression

  • Conclusion:

  • IntravesicalHyaluronan (HA) seems a valid and quicktherapeuticsolutionforiatrogeniccystitisfromchemoorradiotherapy


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