Effects of Different Cystoscopic Bladder Conditions on the Therapeutic Outcomes of Intravesical Platelet-Rich Plasma Injections in Patients with Interstitial Cystitis/Bladder Pain Syndrome

Patients with interstitial cystitis/bladder pain syndrome (IC/BPS) may present with different cystoscopic bladder conditions. The current study investigated the treatment outcomes of repeated intravesical platelet-rich plasma (PRP) injections for various bladder conditions.

This study included 66 patients with IC/BPS, including five with Hunner's IC and 61 with non-Hunner's IC, who were not successfully managed with conventional treatments. The eligible patients underwent videourodynamic studies, completed voiding diaries, and received intravesical PRP injections once a month for a total of four treatments. Cystoscopic hydrodistention was performed, and the maximal bladder capacity and glomerulation grade were recorded. Treatment outcomes were examined using the global response assessment (GRA), and patients with a GRA score of 2 or 3 were considered to have achieved treatment success.

In total, 33 (50%) patients, including 20 (30.3%) who had an excellent outcome (GRA score of 3) and 13 (19.7%) who had moderate improvement (GRA score of 2), reported a successful outcome. The bladder pain visual analog score of 23 (34.8%) patients reduced by ≥ 3, and the functional bladder capacity of 15 (25.9%) patients increased to ≥ 350 mL. The glomerulation grade of 20 (32.8%) patients decreased by ≥ 1. All patients did not report adverse events such as urinary tract infection and urination difficulty. Patients with a baseline MBC of ≥ 760 mL and glomerulation grade of 0 or 1 had relatively higher success rates.

In 50% of patients with IC/BPS, including the non-Hunner's and Hunner's IC subtypes, intravesical PRP injections were effective in reducing bladder pain, increasing bladder capacity, and improving glomerulation grade after cystoscopic hydrodistention. Moreover, patients with reduced bladder inflammation who exhibited a low glomerulation grade and a larger maximal bladder capacity at baseline had a relatively higher treatment success rate.