Amniotic Bladder Therapy in Patients With Interstitial Cystitis / Bladder Pain Syndrome

Document Type

Conference Proceeding

Publication Date

5-2024

Publication Title

Journal of Urology

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 age50.±14.4 years) with a median disease duration of 7 years (5-12years) 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 reconstituted100mg 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 receive done 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.

Volume

211

Issue

5S

First Page

e537

Last Page

e538

Comments

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

DOI

10.1097/01.JU.0001008584.88541.ff.05

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