GAG replenishment therapy for bladder pain syndrome/interstitial cystitis.

To present a rationale for the inclusion of urothelial coating dysfunction in the etipathogenesis of bladder pain syndrome/interstitial cystitis (BPS/IC) and the preclinical and clinical evidence in support of glycosaminoglycan (GAG) replenishment therapy in the treatment of BPS/IC, supplemented by the clinical experience of medical experts in the field and patient advocates attending a symposium on GAG replenishment at ESSIC'17, the annual Meeting of the International Society for the Study of Bladder Pain Syndrome, held in Budapest, Hungary in 2017.

The urothelial GAG layer has a primary role in providing a permeability barrier to prevent penetration of urinary toxins and pathogens into the bladder wall. Disruption of the GAG layer contributes to the development of BPS/IC. The evidence shows that replenishment of GAGs can restore the GAG layer in BPS/IC, reducing inflammation, pain, and other symptoms.

Although data from large randomized controlled studies are limited, long clinical observation and the experience of clinicians and patients support the beneficial effects of intravesical GAG replenishment therapy for providing symptomatic relief for patients with BPS/IC.

Neurourology and urodynamics. 2018 Dec 28 [Epub ahead of print]

Jean Jacques J Wyndaele, Claus Riedl, Rajesh Taneja, Sándor Lovász, Tomohiro Ueda, Mauro Cervigni

Universiteit Antwerpen, Antwerp, Belgium., Urology Department, Landesklinikum Thermenregion, Baden, Austria., Urology and Robotic Surgery, Indraprastha Apollo Hospitals, New Delhi, India., Rózsakert Medical Center, Budapest, Hungary., Department of Urology, Ueda Clinic, Kyoto, Japan., Female Pelvic Medicine & Reconstructive Surgery Center Catholic University, Catholic University, Rome, Italy.