BACKGROUND: Radiotherapy is one of the treatment options for prostate cancer (PCa) but up to 25 % of men report about severe nocturia (nocturnal voiding). The combination of hyaluronic acid (HA) and chondroitin sulfate (CS) resembles glycosaminoglycan (GAG) replenishment therapy. The aim of our study was to evaluate the impact of HA and CS on nocturia, in men with nocturia after PCa radiotherapy.
METHODS: Twenty-three consecutive patients with symptomatic cystitis after external radiotherapy for PCa were enrolled. Patients underwent bladder instillation therapy with HA and CS weekly for the first month and, afterwards, on week 6, 8 and 12. Nocturnal voiding frequency was assessed by item 3 (Q3) of the Interstitial Cystitis Symptoms Index (ICSI) and item 2 (Q2) of the Interstitial Cystitis Problem Index (ICPI). Data were analyzed with paired-samples T-test and adjusted for age.
RESULTS: Eighteen patients (78 %) reported about nocturia. Pre- and post-treatment ICSI-Q3 was 2.13 ± 0.28 and 1.61 ± 0.21 (-24.4 %, p = 0.001). With logistic regression analysis, both age and baseline ICSI-Q3 had a significant impact on nocturnal voiding frequency (r = 0.293, p = 0.011 and r = 0.970, p < 0.001). Pre- and post-treatment ICPI-Q2 was 1.87 ± 0.26 and 1.30 ± 0.25 (-30.5 %, p = 0.016); logistic regression analysis was without significant findings.
CONCLSUION: Bladder instillation treatment with a combination of HA and CS was effective in reducing nocturnal voiding frequency in men with post-radiation bladder pain for PCa. Randomized, controlled trials with sham treatment are needed to confirm our result.
BMC Urol. 2015 Jul 7;15:65. doi: 10.1186/s12894-015-0046-1.
Gacci M1, Saleh O2, Giannessi C3, Detti B4, Livi L5, Monteleone Pasquetti E6, Masoni T7, Finazzi Agro E8, Li Marzi V9, Minervini A10, Carini M11, Gravas S12,Oelke M13, Serni S14.
1 Department of Urology, University of Florence, Careggi Hospital, Largo Brambilla 3, Urologic Clinic San Luca, Florence, 50100, Italy.
2 Department of Urology, University of Florence, Careggi Hospital, Largo Brambilla 3, Urologic Clinic San Luca, Florence, 50100, Italy.
3 Department of Urology, University of Florence, Careggi Hospital, Largo Brambilla 3, Urologic Clinic San Luca, Florence, 50100, Italy.
4 Department of Radiation Therapy, University of Florence, Careggi Hospital, Largo Brambilla 3, Florence, Italy.
5 Department of Radiation Therapy, University of Florence, Careggi Hospital, Largo Brambilla 3, Florence, Italy.
6 Department of Radiation Therapy, University of Florence, Careggi Hospital, Largo Brambilla 3, Florence, Italy.
7 Department of Radiation Therapy, University of Florence, Careggi Hospital, Largo Brambilla 3, Florence, Italy.
8 Department of Urology, Tor Vergata University, Via di Tor Vergata, Rome, Italy.
9 Department of Urology, University of Florence, Careggi Hospital, Largo Brambilla 3, Urologic Clinic San Luca, Florence, 50100, Italy.
10 Department of Urology, University of Florence, Careggi Hospital, Largo Brambilla 3, Urologic Clinic San Luca, Florence, 50100, Italy.
11 Department of Urology, University of Florence, Careggi Hospital, Largo Brambilla 3, Urologic Clinic San Luca, Florence, 50100, Italy.
12 Department of Urology, University Hospital of Larissa, Larissa, Greece.
13 Department of Urology, Hannover Medical School, Hannover, Germany.
14 Department of Urology, University of Florence, Careggi Hospital, Largo Brambilla 3, Urologic Clinic San Luca, Florence, 50100, Italy.