The efficacy and safety of platelet-rich plasma in treating interstitial cystitis/bladder pain syndrome
10.3760/cma.j.cn112330-20240612-00263
- VernacularTitle:富血小板血浆治疗间质性膀胱炎/膀胱疼痛综合征的有效性和安全性
- Author:
Qiangping ZHENG
1
;
Lei ZHANG
;
Jianzhong ZHANG
;
Sai LIU
;
Fan ZHANG
;
Peng ZHANG
Author Information
1. 首都医科大学附属北京朝阳医院泌尿外科，北京 100020
- Publication Type:Journal Article
- Keywords:
Platelet-rich plasma;
Interstitial cystitis/Bladder pain syndrome;
Intravesical injection
- From:
Chinese Journal of Urology
2024;45(10):745-750
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy and safety of platelet-rich plasma (PRP) in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS).Methods:This prospective study included patients diagnosed with IC/BPS who received multiple PRP injections at our hospital from January 2023, to April 2024. Inclusion criteria included patients over 18 years old with symptoms of urinary frequency, urgency, pain, and pelvic pain, patients who were required to have confirmed non-ulcerative IC/BPS via cystoscopic hydrodistension under anesthesia and exclusion of other diseases through urodynamic and imaging tests, patients who failed to improve after more than three treatments including lifestyle intervention, intravesical hyaluronic acid instillation, botulinum toxin injection, or cystoscopic hydrodistension, and they all signed sign informed consent for the procedures. Exclusion criteria included active urinary tract infection, use of anticoagulants or antiplatelet drugs, T-cell lymphoma causing systemic autoimmune disease, platelet count below 100×10 9/L, hemoglobin level below 100 g/L, severe cardiovascular disease, or other conditions that preclude platelet apheresis. Approximately 100 ml of PRP was collected from each patient using a blood cell separator, with 1 ml reserved for platelet detection and the remaining PRP divided into six bags, each containing about 15 ml. Patients received one PRP injection per month, for a total of six injections. Each injection involved 30 evenly distributed sites on the bladder wall under cystoscopic visualization, with 0.5 ml injected per site. The primary endpoint was global response assessment (GRA), conducted approximately one month after each procedure, with GRA≥5 indicating improvement and GRA≥6 indicating good efficacy. Secondary endpoints included assessments of 24-hour urinary frequency, nocturia, functional bladder capacity, O'Leary-Sant scores [including the IC Symptom Index (IC-SI) and IC Problem Index (IC-PI)], pelvic pain and urgency/frequency (PUF) scores, visual analogue scale (VAS) for pain, and quality of life (QOL) scores, evaluated preoperatively and one month after each treatment. Results:A total of 21 patients were enrolled in the study, including 2 males and 19 females, with an average age of (37.10±14.75) years and an average preoperative disease duration of (4.05±3.25) years. The average bladder capacity under general anesthesia before the procedure was (502.86±150.84) ml. Among these patients, 11 completed six injections, 6 completed five injections, and 4 completed four injections. After four treatments, 17 patients had a GRA≥5, and 11 patients had a GRA≥6, with an improvement rate (GRA≥5) of 80.95%. Following the most recent treatment, 18 patients had a GRA≥5, and 12 had a GRA≥6, with an overall improvement rate (GRA≥5) of 85.71%. Comparison of clinical data before surgery and one month after the fourth treatment showed significant differences in functional bladder capacity [(203.10±77.74) ml vs. (254.52±115.95 ml)], O'Leary-Sant scores [(20.90±7.94) vs. (15.81±8.47)], VAS scores [(3.55±3.00) vs. (2.14±2.22)], and QOL scores [(4.24±1.00) vs. (3.43±1.29)] ( P<0.05). In 17 patients who completed five injections, comparison of data one month after the fourth and fifth treatments showed significant differences in O'Leary-Sant scores [(15.41±8.64) vs. (13.65±8.13)] ( P<0.05). In 11 patients who completed six injections, there were no statistically significant differences in any indicators between one month after the fifth and sixth treatments. As for surgical complications, only one patient experienced gross hematuria after the fourth treatment, and no other significant postoperative complications were observed. Conclusions:Intravesical PRP injections for the treatment of IC/BPS are effective and safe.
