Alternativa terapéutica para el dolor pélvico crónico de origen vesical

P.Á. López González, Pedro A. López González, J.I. Tornero Ruíz, Pedro López Cubillana, Gloria Doñate Iñiguez, J.C. Ruiz Morcillo, M. Pérez Albacete
In: Actas Urológicas Españolas · 2009 · vol. 33(6) , pp. 681–685 · doi:10.1016/s0210-4806(09)74207-x · PMID:19711752 · W2139530578
article OA: closed CC0 ⤵ 2 in-corpus citations
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This paper explores an alternative therapeutic approach for chronic pelvic pain originating from the bladder.

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Abstract

IntroductionChronic pelvic pain syndrome (CPPS) is a complex problem that is a major cause of morbidity and disability.ObjectiveTo evaluate the feasibility, safety and efficacy of intravesical instillation of a new therapeutic tool in patients suffering from CPPS.MethodsBetween june 2005 and september 2008 we recruited 14 patients (mean age 59) who had been diagnosed with CPPS, and refractory to previous treatments. The intravesical solution consisted of steroids, local anaesthetic, antibiotic and saline solution. Was evaluated the intensity of pain; voiding frequency and subjective improvement (with patient global improvement impression PGI-I).ResultsGlobal pain at baseline was 6.4, at 1 month and 6 months 4.7 and 3.5. 75% of the patients showed improvement in the reduction of pain. Voiding frequency at baseline was 22'5 daily. At one and six months, voiding frequency was 16,2 and 13,5 respectively. According to the PGI-I test 30% of patients were much better, 30% moderate improvement, 10% slight improvement and 30% with no changes at 1 month. At 6 months, 15% of patients were much better, 40% moderated improvement, 15% slight improvement and 30% with no changes. None of the patients felt worse than before treatment.ConclusionsTherapeutic results of our intravesical solution traduces in an improvement of pain and voiding frequency reduction with no side-effects. Patients benefit of this improvement in the PGI-I test that reflects an improvement in quality of life. We consider this treatment a second-line approach for CPPS in which gold standard management is still a challenge.

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