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Abstract
We performed a prospective, single-arm study comparing outcomes between transurethral ablation plus postoperative instillation of hyaluronic acid and chondroitin sulfate (HACS group) and transurethral ablation only in patients with Hunner type interstitial cystitis (historical control group). A total of 78 patients were enrolled, and 51 were included in the per-protocol analysis set. The 2-year recurrence rate was 47.1% (95% CI, 32.9–61.5) in the HACS group, which was significantly lower than that in the control group (86.2%; 95% CI, 74.6–93.9, P < 0.001). After instillation therapy, the hazard ratio for recurrence was 0.38 (95% CI, 0.23–0.65, P < 0.001). The HACS group had an increased recurrence-free survival with the median interval not being reached, while it was 11.4 months in the control group (95% CI, 8.8–13.8, P < 0.001). Regardless of the instillation treatment, there were significant improvements in all symptom questionnaire scores and pain compared to the baseline. However, in the instillation group, improvement was stable even after 12 months. In patients with Hunner type interstitial cystitis, intravesical instillation of hyaluronic acid and chondroitin sulfate after transurethral ablation significantly reduced the recurrence rate and maintained symptom improvement for more than 1 year.
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1 Sungkyunkwan University School of Medicine, Department of Urology, Samsung Medical Center, Seoul, Korea (GRID:grid.264381.a) (ISNI:0000 0001 2181 989X)
2 The Catholic University of Korea, Department of Urology, Seoul St. Mary’s Hospital, College of Medicine, Seoul, Korea (GRID:grid.411947.e) (ISNI:0000 0004 0470 4224)
3 Keimyung University School of Medicine, Department of Urology, Dongsan Medical Center, Daegu, Korea (GRID:grid.412091.f) (ISNI:0000 0001 0669 3109)
4 Research Institute for Future Medicine, Samsung Medical Center, Biomedical Statistics Center, Seoul, Korea (GRID:grid.414964.a) (ISNI:0000 0001 0640 5613)
5 Research Institute for Future Medicine, Samsung Medical Center, Biomedical Statistics Center, Seoul, Korea (GRID:grid.414964.a) (ISNI:0000 0001 0640 5613); Sungkyunkwan University, Department of Digital Health, SAIHST (Samsung Advanced Institute for Health Sciences & Technology), Seoul, Korea (GRID:grid.264381.a) (ISNI:0000 0001 2181 989X); Sungkyunkwan School of Medicine, Department of Data Convergence & Future Medicine, Seoul, Korea (GRID:grid.264381.a)
6 Sungkyunkwan University School of Medicine, Department of Urology, Samsung Medical Center, Seoul, Korea (GRID:grid.264381.a) (ISNI:0000 0001 2181 989X); Research Institute for Future Medicine Samsung Medical Center, Seoul, Korea (GRID:grid.414964.a) (ISNI:0000 0001 0640 5613)