(823) Hyaluronic Acid and Chondroitin Sulphate Instillation in Bladder Chronic Diseases: A Meta-Analysis

Introduction Deficiency of glycosaminoglycans (GAGs) layer on urothelial epithelial cells has been involved in the pathogenesis of chronic invalidating bladder diseases including bladder pain syndrome (BPS), recurrent urinary tract infections (rUTI) and post-radiation cystitis (pRC). Objective To systematically summarize and meta-analyze all uncontrolled and controlled studies evaluating the role of intravesical instillation of hyaluronic acid (HA), with or without chondroitin sulphate (ChS), in the treatment of BPS, rUTI and pRC. Methods Publications from January 1st, 1969, up to August 31st, 2024 were retrieved from multiple databases. Data were analysed using random-effects and common-effects models with subgroup and sensitivity analyses. Results Out of 131 studies, 30, 10 and 3 papers investigating the use of HA/ChS in patients with BPS and rUTI or pRC, respectively, were included in the analyses. The use of HA/ChS resulted in a significant improvement in pain as well as voiding and irritative symptoms in all the investigated conditions. In addition, the treatment can reduce the risk of rUTI when compared to standard care. In particular, although limited data were available, when randomized controlled trials were investigated the combined use of the HA/ChS resulted in better outcomes and a lower infection rate compared to either placebo or standard of care (OR=0.42[0.25;0.49]; p<0.0001). Finally, an improvement in sexual function and quality of life was also observed. Conclusions Present data show that intravesical HA/ChS administration represents a promising approach for patients with BPS, rUTI and pRC. Disclosure No