The efficacy of high concentration oxygen and hyaluronic acid for the treatment of urethral pain syndrome

Abstract

Objective: To evaluate the efficacy of the association between high concentration oxygen and hyaluronic acid for treatment of urethral pain syndrome (UPS) identified by persistent or recurrent urethral daily pain usually on emptying the bladder and nocturia, in the absence of proven infectious agents such as the urinalysis or any inflammatory background.
Methods: Twenty women (45-65 years) with suspected UPS diagnosis appealing to our Second Opinion Medical Consultation Network, signed an informed consent form and were treated with oxygen +hyaluronic acid therapy, once a week, for a total of five weeks at the outpatient clinic (Clinic Ester Veronesi, Modena, Italy). The physicians of the Second Opinion Network followed up remotely once a week (WhatsApp, Skype) assessing effectiveness, tolerability, and side effects of the treatment.
Results: There was a reduction in the number of urgency urinary incontinence (−25.37 vs. −12.01 mean value), nocturia episodes (−24.01 vs. −11.23 mean value), volume voided in each micturition (-127.79 vs. -98.20 mean value), micturition per 24 hours (−44.01 vs. −20.12 mean value). Analyses of the pre- and post-treatment scores showed a statistically significant improvement in Vaginal Assessment Scale (VAS), the Pain Urgency frequency (PUF) and Patient Perception of Bladder Condition scale (PPBC) scores (p< 0.0305, p<0.0001, p<0.0001, respectively). No side effects associated with the treatment were reported by the patients. Conclusions: We can highlight that the combination of oxygen + hyaluronic acid was effective and well tolerated for the management of the UPS syndrome. Oxygen flow mixed with hyaluronic acid, provides an immediate sense of freshness and urethro-bladder relaxation that lasts several hours. Further studies are recommended that include larger sample sizes, comparison with placebo and/or challenge with other local and systemic treatments and different administration schedules versus longer follow up.

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