Intravesical injections of platelet‐rich plasma is effective and safe in treatment of interstitial cystitis refractory to conventional treatment—A prospective clinical trial

Jhang, Jia‐Fong; Lin, Teng-Yi; Kuo, Hann‐Chorng

doi:10.1002/nau.23898

Cited by 35 publications

(66 citation statements)

References 26 publications

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“…The urodynamic parameters at baseline showed no significant difference from those at 3 months after the 4th PRP injection. However, 20/27 (74.1%) of patients with a successful result had a negative KCl test after PRP treatment, while 11/13 patients (84.6%) with a failed result continued to show positive KCl test after PRP treatment 21 .…”

Section: Resultsmentioning

confidence: 97%

“…PRP has been widely used in the treatment of orthopedic and soft-tissue inflammation; however, their role in the treatment of bladder disorders is not well characterized. In our previous pilot study, repeated intravesical injections of PRP were found to alleviate the symptoms of IC 20,21 . However, clinical therapeutic efficacy of any novel treatment for IC/BPS is liable to be affected by subjective perception of improvement.…”

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confidence: 88%

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Repeated intravesical injections of platelet-rich plasma improve symptoms and alter urinary functional proteins in patients with refractory interstitial cystitis

Jiang

Kuo

Jhang

et al. 2020

Sci Rep

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Repeated intravesical injections of autologous platelet-rich plasma (PRP) have been shown to improve symptoms in patients with interstitial cystitis/bladder pain syndrome (IC/BPS); however, there is a paucity of objective evidence of the effectiveness of this therapy. In this study, we investigated the changes in urinary markers after PRP treatment. Forty patients with IC/BPS who were refractory to conventional therapy received four injections of PRP at monthly intervals; 10 mL PRP solution with 2.5 times the peripheral blood platelet concentration was used. Urine levels of thirteen functional proteins, growth factors, and cytokines were assessed at baseline and at the 4th PRP injection. The clinical parameters included visual analog scale (VAS) pain score, daily urinary frequency, nocturia episodes, functional bladder capacity, and global response assessment (GRA). The GRA and symptom score significantly decreased post-treatment. In patients with GRA ≥ 2, the success rates at 1 month and at 3 months after the 4th PRP injection were 70.6% and 76.7%, respectively. The VAS pain score, frequency, and nocturia showed a significant decrease (all p < 0.05). Urinary levels of nerve growth factor, matrix metalloproteinase-13, and vascular endothelial growth factor significantly decreased post-treatment (p = 0.043, p = 0.02, and p = 0.000, respectively); platelet-derived growth factor-AB showed a significant increase (p = 0.004) at the 4th PRP treatment compared with baseline. In this study, repeated intravesical PRP injections provided significant symptom improvement in IC/BPS patients with concomitant changes in the related biomarker levels. Trial registration: ClinicalTrial.gov: NCT03104361; IRB: TCGH 105-48-A.

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Section: Resultsmentioning

confidence: 97%

mentioning

confidence: 88%

Repeated intravesical injections of platelet-rich plasma improve symptoms and alter urinary functional proteins in patients with refractory interstitial cystitis

Jiang

Kuo

Jhang

et al. 2020

Sci Rep

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“…Patients with Hunner's lesion received electrocauterization and partial cystectomy plus enterocystoplasty . Recently, we even tried intravesical platelet‐rich plasma instillation in IC/BPS patients to improve their urothelial regeneration ability and resume a healthy barrier function …”

Section: Discussionmentioning

confidence: 99%

“…We can see from the treatment results of this long‐term follow‐up, pain VAS improved both in regular treatment and lost to follow‐up patient groups. Recent clinical trials of Botox and PRP also found these treatments are effective in reducing pain, but not very effective in improvement of frequency urgency …”

Section: Discussionmentioning

confidence: 99%

Long‐term outcome and symptom improvement in patients with interstitial cystitis/bladder pain syndrome with or without regular follow‐up and treatment

Yeh

Jhang

Kuo

et al. 2019

Neurourology and Urodynamics

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Aims: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic disease, which is difficult to treat. Patients usually seek for new therapies and might not follow-up regularly. This study investigated long-term symptom changes in patients with IC/BPS, especially in those who were lost to follow-up. Methods: We enrolled patients with IC/BPS with a history of >5 years and having comprehensive medical records, baseline IC symptom index and IC problem index, O'Leary-Sant symptom score, and visual analog scale (VAS). A telephone interview was conducted to assess current symptoms with the same questionnaires. A 5-point scale (from −1 to 3) was used to grade current treatment outcomes.Results: A total of 198 patients with IC/BPS with a mean age of 57.4 ± 12.2 years were included. At a mean follow-up duration of 16.6 ± 9.75 years, 12% of the patients were free of symptoms and 47% exhibited symptom improvement of more than 50%. Totally, 47 (23.7%) patients were lost to follow-up for >5 years, and 151 (76.3%) had a regular follow-up. The patients with IC/BPS who were not regularly followed up had no Hunner's lesion, and had a higher bladder volume (P = .023), higher urine flow (P = .019), and fewer comorbidities (P = .014) than those who had a regular follow-up. The number of treatment modalities was significantly less in the patients who were lost to follow-up (P = .037).Conclusions: About half of the patients with IC/BPS exhibited symptom improvement with time, with or without regular follow-up and receiving a new treatment.

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“…In addition, the significant posttreatment increases of urinary IL-2 and IL-8 in these IC patients suggest that immune modulation of PRP may play a role in the relief of IC/BPS symptoms. In a subsequent clinical trial, Jhang et al [54] further reported the outcomes of IC patients who received repeated PRP (10 mL extracted from 50 mL of whole blood) intravesical injections 4 times in 1 month . In that study, 67.5% of IC participants showed improvement of IC/BPS symptoms and increased functional capacity at a 3-month follow-up.…”

Section: Therapeutic Effects Of Prp On Ic/bpsmentioning

confidence: 99%

New Frontiers or the Treatment of Interstitial Cystitis/Bladder Pain Syndrome - Focused on Stem Cells, Platelet-Rich Plasma, and Low-Energy Shock Wave

et al. 2020

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Interstitial cystitis/bladder pain syndrome (IC/BPS), which is characterized by bladder pain and irritative voiding symptoms, is a frustrating disease without effective treatment. The cause is still largely not understood, although urothelium ischemia/hypoxia, apoptosis, denudation, and infiltration of inflammatory cells are common histopathological findings. The current uncertainty regarding the etiology and pathology of IC/BPS has a negative impact on its timely and successful treatment; therefore, the development of new treatment modalities is urgently needed. Herein, we present advances in our knowledge on this topic and review the potential application of regenerative medicine for the treatment of IC/BPS. This article provides information on the basic characteristics and clinical evidence of stem cells, platelet-rich plasma (PRP), and low-energy shock waves (LESWs) based on a literature review with a search strategy for articles related to IC/BPS, stem cells, PRP, and LESW published in MEDLINE and PubMed. Stem cells, PRP, and LESW, which modulate inflammatory processes and promote tissue repair, have been proven to improve bladder regeneration, relieve bladder pain, inhibit bladder inflammation, and increase bladder capacity in some preclinical studies. However, clinical studies are still in their infancy. Based on the mechanisms of action of stem cells, PRP, and LESW documented in many preclinical studies, the potential applications of regenerative medicine for the treatment of IC/BPS is an emerging frontier of interest. However, solid evidence from clinical studies remains to be obtained.

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Intravesical injections of platelet‐rich plasma is effective and safe in treatment of interstitial cystitis refractory to conventional treatment—A prospective clinical trial

Cited by 35 publications

References 26 publications

Repeated intravesical injections of platelet-rich plasma improve symptoms and alter urinary functional proteins in patients with refractory interstitial cystitis

Repeated intravesical injections of platelet-rich plasma improve symptoms and alter urinary functional proteins in patients with refractory interstitial cystitis

Long‐term outcome and symptom improvement in patients with interstitial cystitis/bladder pain syndrome with or without regular follow‐up and treatment

New Frontiers or the Treatment of Interstitial Cystitis/Bladder Pain Syndrome - Focused on Stem Cells, Platelet-Rich Plasma, and Low-Energy Shock Wave

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