Efficacy of hyperbaric oxygenation in the complex treatment of women suffering interstitial cystitis/painful bladder

Abstract

Introduction. Interstitial cystitis/painful bladder (IC / BMP) is a rare, chronic, and disabling disease. Treatment of IC / BMP is empirical in the scope of physiotherapy procedures, taking antidepressants, pentosan sodium salt sulfate, intravesical administration of lidocaine and heparin, as well as various types of surgical interventions — mainly aimed at relieving the symptoms of the disease. The effectiveness of the latter does not exceed 60%, and symptoms return even when a period of remission seems to have occurred. The article presents the experience of our clinic in treating women with IC / BMP using hyperbaric oxygenation (HBO).Purpose of the study. To study the effectiveness of HBO in complex therapy patients suffering IC / BMP in the form of ulcerative lesions.Materials and methods. The study included 40 women, average age 60.1 ± 10.5 years, with the classic form of IC / BMP. All patients were examined and included in the study according to the NIDDK criteria. The patients were divided into 2 groups: Group I — women who received complex therapy with HBO (n = 20), Group II — only complex therapy (n = 20). Group I women received treatment: transurethral coagulation of Gunner's lesion zones, bladder hydrodistension, tricyclic antidepressants, intravesical instillations of lidocaine, dimethylsulfoxide, and a course of HBO. HBO consisted of 10 sessions (40 min, 2 ATM). Group II patients received the same IC / BMP therapy as the group I women, to the same extent, but without HBO.Results. Indicators of the PUF scale after 6 months of therapy in Groups I and II were 14.2 and 21.2 points, respectively. The average score in Group I was 3.48, in Group II — 5.13 according to the visual analogue pain scale. The cystometric capacity of the bladder in both groups after treatment was stable, its value was at least 320 ml. The number of urinations after combined therapy with HBO after 1, 3 and 6 months was 12 times a day. Whereas it was 14 times a day in Group II after 1 month, and it was 15 times a day after 3 and 6 months.Conclusions. The index of IC assessment, indicators of the visual-analogue pain scale, the cystometric capacity of the bladder, and the number of urinations improved after standard treatment but were significantly worse than in patients who received HBO additionally. Treatment with HBO leads to a statistically significant improvement, only in combination with the therapy, both according to questionnaires, and the function of accumulation and emptying of the bladder. For patients with IC/BMP who had ineffective standard treatment, it makes sense to conduct HBO, which can be an important stage of therapy and contribute to a longer remission of the disease.

Keywords

• urology
• interstitial cystitis
• interstitial cystitis / bladder pain syndrome
• bladder pain syndrome
• hyperbaric oxygenation