Pd25-05 Amniotic Bladder Therapy in Patients With Interstitial Cystitis/Bladder Pain Syndrome

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Interstitial Cystitis (PD25)1 May 2024PD25-05 AMNIOTIC BLADDER THERAPY IN PATIENTS WITH INTERSTITIAL CYSTITIS/BLADDER PAIN SYNDROME Raghav Madan, Codrut Radoiu, Jack Vercnocke, Aron Liaw, Steven Lucas, Alaa Hamada, and Nivedita Dhar Raghav MadanRaghav Madan , Codrut RadoiuCodrut Radoiu , Jack VercnockeJack Vercnocke , Aron LiawAron Liaw , Steven LucasSteven Lucas , Alaa HamadaAlaa Hamada , and Nivedita DharNivedita Dhar View All Author Informationhttps://doi.org/10.1097/01.JU.0001008584.88541.ff.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Our study hypothesis postulates that if patients with Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) bladders exhibit increased inflammation, fibrosis, and urothelial dysfunction then treatment methods that modulate inflammation and fibrosis, while promoting a regenerative urothelium environment may have a therapeutic effect in such patients. Amniotic membrane (AM) has been shown to foster a regenerative wound-healing environment through its anti-inflammatory and anti-fibrotic properties. In this study, we investigate the safety and efficacy of bladder injections of AM in patients with treatment resistant IC/BPS. METHODS: Fifteen consecutive IC/BPS patients (mean age 50.7±14.4 years) with a median disease duration of 7 years (5-12 years) who were recalcitrant to multiple therapies including anti-cholinergic (n=15), beta-3 adrenergic agonist (n=15), tricyclic anti-depressant (n=15), anti-histamine (n=5), hydrodistension (n=15), pentosan polysulfate (n=9), vaginal valium (n=15), intravesical instillation (n=8), botulinum toxin (Botox) injection (n=15), and neuromodulation (n=5) were included in the study. Under general anesthesia patients received intra-detrusor injections of reconstituted 100mg micronized AM and were followed for 24 weeks. Clinical evaluation and patient-reported outcome measures including Interstitial Cystitis Symptom Index (ICSI), Interstitial Cystitis Problem Index (ICPI), Bladder Pain/ Interstitial Cystitis Symptom Score (BPIC-SS), Overactive Bladder Assessment Tool (OAB) were assessed. RESULTS: After amniotic bladder therapy (ABT), the lower urinary tract symptoms improved gradually up to 12 weeks in all patients. At 16 weeks, 3 patients experienced a resurgence of symptoms and requested another injection which resulted in improvement after 2, 4, and 8 weeks respectively. For the twelve patients who only received one injection, the symptoms were still significantly lower at 20 and 24 weeks compared to baseline. (Figure 1) No safety concerns were noticed during the study. CONCLUSIONS: Our findings suggest that ABT shows promise as a treatment for refractory IC/BPS patients. However, further study is needed to establish treatment protocol, better understand the mechanism of action and determine the durability of therapeutic response of ABT in IC/BPS. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e537 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Raghav Madan More articles by this author Codrut Radoiu More articles by this author Jack Vercnocke More articles by this author Aron Liaw More articles by this author Steven Lucas More articles by this author Alaa Hamada More articles by this author Nivedita Dhar More articles by this author Expand All Advertisement PDF downloadLoading ...