Intravesical instillation of platelet-rich plasma for treatment of interstitial cystitis/bladder pain syndrome: A pilot study

Abstract

Objective: The aim of this study was to evaluate the feasibility of intravesical instillation of platelet-rich plasma (PRP) to treat interstitial cystitis/bladder pain syndrome (IC/BPS).

Materials and methods: Twenty PRP samples were tested in vitro for stability after exposure to urine samples with different pH. A pilot study involving 21 female patients with IC/BPS was conducted, and 6 weekly doses of autologous PRP (50 mL) were administered. Patients were followed up at the 2nd, 4th, 8th, and 12th weeks after terminating instillation. The primary endpoint was the visual analog scale (VAS) for pain, and the secondary endpoints included the IC symptom index, IC problem index of the O'Leary-Sant questionnaire and global response assessment, urine culture, and uroflowmetry. Success was defined as a reduction in VAS by 30% or more compared with basal level, and adverse events were recorded.

Results: The mean ± SD of VAS was significantly reduced compared with basal level (4.4 ± 2.6 vs. 8.8 ± 1.1, respectively, p = 0.001). Meanwhile, 80% of cases were considered successful, with a 50.1% reduction in the mean score compared with the basal level. The mean ± SD of IC symptom index and IC problem index significantly improved compared with the basal level. Global response assessment was markedly, moderately, and slightly improved in 2 (10%), 10 (50%), and 5 (25%) patients, respectively, and showed no change in 3 (15%). Three patients had positive urine cultures at follow-up, but 1 withdrew after 2 sessions because of a lack of efficacy.

Conclusions: Repeated intravesical instillation of PRP could be considered an effective and safe approach for treating IC/BPS.

Keywords

Bladder pain syndrome / Interstitial cystitis / Platelet-rich plasma

Author summay

Supplemental Digital Content is available for this article.

Acknowledgments

None.

Statement of ethics

This study gained institutional review board approval from the Faculty of Medicine, Mansoura University (Code Number: MS.19.03.540). Informed written consent was obtained from all patients. All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Conflict of interest statement

No conflict of interest has been declared by the authors.

Funding source

This research received no specific grants from any funding agency in the public, commercial, or not-for-profit sectors.

Author contributions

ASEH: Conception, study design, data analysis and drafting; MAAH: Data collection and follow up of cases; EES: Preparation of platelet-rich plasma; MA-R: Preparation of platelet-rich plasma; NE-T: Supervision.

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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