REVIEW ARTICLE
GAG replenishment therapy for bladder pain syndrome/interstitial cystitis
Jean Jacques J Wyndaele MD,PhD,
Claus Riedl MD,
Rajesh Taneja MD,
Sándor Lovász MD,PhD,
Tomohiro Ueda MD,PhD,
Mauro Cervigni MD,
Jean Jacques J Wyndaele MD,PhD
Universiteit Antwerpen, Antwerp, Belgium
Search for more papers by this authorClaus Riedl MD
Urology Department, Landesklinikum Thermenregion, Baden, Austria
Search for more papers by this authorRajesh Taneja MD
Urology and Robotic Surgery, Indraprastha Apollo Hospitals, New Delhi, India
Search for more papers by this authorSándor Lovász MD,PhD
Rózsakert Medical Center, Budapest, Hungary
Search for more papers by this authorTomohiro Ueda MD,PhD
Department of Urology, Ueda Clinic, Kyoto, Japan
Search for more papers by this authorCorresponding Author
Mauro Cervigni MD
Female Pelvic Medicine & Reconstructive Surgery Center Catholic University, Catholic University, Rome, Italy
Correspondence
Mauro Cervigni, Interstitial Cystitis Referral Center, Catholic University, Largo F. Vito 1, Rome 00100, Italy.
Email: [email protected]
Search for more papers by this authorJean Jacques J Wyndaele MD,PhD,
Claus Riedl MD,
Rajesh Taneja MD,
Sándor Lovász MD,PhD,
Tomohiro Ueda MD,PhD,
Mauro Cervigni MD,
Jean Jacques J Wyndaele MD,PhD
Universiteit Antwerpen, Antwerp, Belgium
Search for more papers by this authorClaus Riedl MD
Urology Department, Landesklinikum Thermenregion, Baden, Austria
Search for more papers by this authorRajesh Taneja MD
Urology and Robotic Surgery, Indraprastha Apollo Hospitals, New Delhi, India
Search for more papers by this authorSándor Lovász MD,PhD
Rózsakert Medical Center, Budapest, Hungary
Search for more papers by this authorTomohiro Ueda MD,PhD
Department of Urology, Ueda Clinic, Kyoto, Japan
Search for more papers by this authorCorresponding Author
Mauro Cervigni MD
Female Pelvic Medicine & Reconstructive Surgery Center Catholic University, Catholic University, Rome, Italy
Correspondence
Mauro Cervigni, Interstitial Cystitis Referral Center, Catholic University, Largo F. Vito 1, Rome 00100, Italy.
Email: [email protected]
Search for more papers by this authorEnrico Finazzi Agro led the peer-review process as the Associate Editor responsible for the paper
Abstract
Aims
To present a rationale for the inclusion of urothelial coating dysfunction in the etipathogenesis of bladder pain syndrome/interstitial cystitis (BPS/IC) and the preclinical and clinical evidence in support of glycosaminoglycan (GAG) replenishment therapy in the treatment of BPS/IC, supplemented by the clinical experience of medical experts in the field and patient advocates attending a symposium on GAG replenishment at ESSIC’17, the annual Meeting of the International Society for the Study of Bladder Pain Syndrome, held in Budapest, Hungary in 2017.
Results
The urothelial GAG layer has a primary role in providing a permeability barrier to prevent penetration of urinary toxins and pathogens into the bladder wall. Disruption of the GAG layer contributes to the development of BPS/IC. The evidence shows that replenishment of GAGs can restore the GAG layer in BPS/IC, reducing inflammation, pain, and other symptoms.
Conclusions
Although data from large randomized controlled studies are limited, long clinical observation and the experience of clinicians and patients support the beneficial effects of intravesical GAG replenishment therapy for providing symptomatic relief for patients with BPS/IC.
CONFLICT OF INTEREST
J J Wyndaele, C Riedl, S Lovász, and T Ueda declare that there are no conflicts of interest. M Cervigni reports non-financial support from IBSA, during the conduct of the study. R Taneja declares work as an advisor to Swati Spentose Pvt Limited.
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