Abstract

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• OBJECTIVES:

  Interstitial cystitis/Painful bladder syndrome (IC/PBS) is a chronic bladder condition of unknown etiology and pathogenesis. However, there is evidence of bladder surface mucosal and glycosaminoglycans (GAG) dysfunction in IC/PBS and GAG replacement therapy has been used to treat the condition. The results of an open label, uncontrolled study of a dietary supplement designed to improve GAG mucopolysaccharides integrity (glucosamine sulfate, sodium hyaluronate and chondroitin sulfate) and reduce bladder wall inflammation (quercetin, rutin) are presented herein. METHODS: Two hundred fifty two IC/PBS patients (25 men, 227 women; 18-69 years old), who had failed other treatments, took four CystoProtek capsules /day (mg/capsule: glucosamine sulfate, 120; chondroitin sulfate, 150; hyaluronate sodium, 10; quercetin, 150; rutin, 20). Symptoms were evaluated using a visual analogue scale (VAS) (severity range from 1-10) before and after treatment (< 6, 6-12 or > 12 months). The women were divided into two severity groups - a more severe A group with a baseline mean VAS score greater than or equal to 5 and a less severe B group with a mean score < 5.

  RESULTS:

  Male patients (55.72 ± 9.53 years, n = 25) had a mean VAS score at baseline of 7.6 ± 1.63 which fell 51.8% to 3.94 ± 2.46 (p < 0.0001) after 12.46 ± 8.76 months of treatment. The women (n = 227) experienced a 48.8% reduction in the mean VAS score (p < 0.0001) after 11.2 ± 8.7 months. The mean VAS score in Group A (49.72 ? 11.39 years, n = 207) fell 52.1% from 7.91 ± 1.55 to 3.79 ± 2.37 (p < 0.0001) after 11.06 ± 8.18 months and in Group B (52.40 ± 10.19 years, n = 20) fell 43.5% from 3.15 ± 0.92 to 1.78 ? 1.63 (p = 0.013) after 10.10 +/- 5.80 months. Patients in Group A and B were further subdivided into Groups A1, B1 (> 12 months), A2, B2 (6-12 months) and A3, B3 (< 6 months treatment); improvement was statistically significant in all the more severe Group A treatment duration subgroups.

  CONCLUSIONS:

  Dietary supplements targeting the bladder GAGs (chondroitin, glucosamine, hyaluronate) and bladder inflammation (quercetin, rutin) are useful in the treatment of refractory IC/PBS. Prospective randomized trials of such supplements are warranted in both treatment refractory and treatment na?ve patients.