Durability of Response of Amniotic Bladder Therapy in Patients With Chronic Radiation Cystitis

Document Type

Conference Proceeding

Publication Date

5-2024

Publication Title

Journal of Urology

Abstract

INTRODUCTION AND OBJECTIVE: Chronic radiation cystitis(CRC) triggers activation of an inflammatory cascade of events culminating in chronic inflammation, vascular injury and resultant fibrosis. Amniotic membrane (AM) with its immunomodulatory, vasculogenic and anti-fibrotic properties is emerging as a potential therapeutic option to treat recalcitrant CRC patients. We have previously reported that amniotic bladder therapy (ABT) provides symptomatic improvement in refractory CRC patients for up to 12 weeks. Herein, we evaluated the durability of ABT up to 36 weeks. METHODS: Five consecutive CRC patients (mean age: 64±20 years) refractory to multiple therapies including botulinum toxin injection(n[5), anticholinergics (n[5), b3-adrenergic agonist (n[5), tricyclic antidepressant (n[4), vaginal valium (n[4), and hydro-distension (n[3) received intra-detrusor injections under general anesthesia of100 mg reconstituted micronized AM. Clinical evaluation and questionnaires (Interstitial Cystitis Symptom Index (ICSI), Interstitial Cystitis Problem Index (ICPI), Bladder Pain/ Interstitial Cystitis Symptom Score (BPIC-SS), Overactive Bladder (OAB) Assessment Tool) were repeated at pre-injection and at 2, 4, 8, 12, 16, 20, 24,and 36 weeks post-injection. Uroflowmetry was done at baseline and at 12, 24 and 36 weeks post-injection. RESULTS: All five patients exhibited a progressive improvement from their baseline lower urinary tract symptoms to 20 weeks(Figure 1) further corroborated with improvements in uroflow study(Table 1). At 36 weeks, improvement was observed in four of the five patients. No safety concerns were noticed during the study. CONCLUSIONS: Our findings suggest that ABT may hold promise for refractory CRC patients, however these findings need further confirmation on larger cohort of patients to establish its therapeutic potential. Additionally, research is needed to advance our understanding of the mechanisms through which ABT addresses CRC’s multifactorial disorders.

Volume

211

Issue

5S

First Page

e1234

Comments

American Urological Association Annual Meeting, May 3-6, 2024, San Antonio, TX

DOI

10.1097/01.JU.0001008676.21744.5f.07

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