Abstract
Objectives: Our aim was to investigate the efficacy of Flaveran(R), when treating recurrent urinary tract infections (UTIs) and concomitant lower urinary tract symptoms (LUTS). Methods: In a prospective non-randomised study, from 2018-2019, we included 7 patients aged 22 to 44 years.
All were diagnosed with recurrent UTIs according to European Association of Urol- ogy (EAU) criteria, meaning three confirmed UTIs per year or two symptomatic UTIs in a span of six months. During a baseline examination they underwent a cystoscopy with a mucosal biopsy, ultrasound of urinary tract, urine culture, uroflowmetry and in case of persistent strong urinary urgencies cystometry.
The treatment comprised of 10 intravesical instillations in one-week intervals. The efficacy was evaluated after 6 weeks, 3, 6, 12 months using the following validated questionnaires; Pelvic Pain, Urgency, and Frequency (PUF), OverActive Bladder syndrom questionare (OABq), Interstitial Cystitis Symptom Index (ICSI), Interstitial Cystitis Problem Index (ICPI) and urine cultures.
Results: Four patients had a positive baseline urine culture that was treated by a short course of antibiotic therapy. Out of 7 patients, one was excluded because of non-compliance.
During the follow up we recorded two episodes of asymptomatic bacteriuria in two patients and one episode of symptomatic UTI in the third one. All cases were resolved by a course of antibiotics.
Data from validated questionnaires demonstrated positive effect on LUTS and the general quality of life compared to the baseline information. Statistically significant differences were achieved during the last visit at 12th month, PUF (p < 0,05), OABq (p < 0,05), ICSI (p < 0,05) and ICPI (p < 0,05).
Conclusion: Intravesical instillation of hyaluronic acid (Flaveran(R)) proved to have a statistically significant effect when treating recurrent UTIs and concomitant LUTS. Over a 12-month follow-up period, we recorded only one episode of symptomatic UTI.
The treatment was well tolerated and no side effects were recorded.