BERKELEY, CA (UroToday.com) - Interstitial cystitis/painful bladder syndrome (IC/PBS) presents with a constellation of symptoms including bladder pain, frequency, and urgency. Proposed etiology for the symptoms of IC/PBS includes bladder ischemia and reperfusion injury. Previous reports showed pathological findings of IC/PBS focusing on ischemia and a reduction in bladder capacity due to fibrosis of the bladder wall. Indeed, hyperbaric oxygen therapy has been reported to be effective in patients with IC/PBS resistant to conventional treatments. Previous other studies using an experimental cystitis animal model revealed that free radical-mediated tissue damage is also involved in the pathogenesis. Recently, several investigators showed that hydrogen (H2) has potential as an antioxidant in preventive and therapeutic applications. These findings led us to consider the possibility that hydrogen-rich water might be useful as a therapeutic supplement for IC/PBS. In the present study, we assessed whether supplementation with hydrogen-rich water had beneficial effects on the symptoms in patients with IC/PBS.
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We conducted a prospective, randomized, double-blind, placebo-controlled clinical trial of hydrogen-rich water in patients with IC/PBS. They were randomized by 2:1 ratio to receive hydrogen-rich water vs placebo water for 8 weeks. Symptoms were assessed using the O’Leary-Sant validated Interstitial Cystitis Symptom Index (ICSI), IC problem index, the Pelvic Pain and Urgency/Frequency (PUF) Patient Symptom Scale, visual analog scale (VAS) bladder pain scores, and a standard 3-day voiding diary. A total of 30 participants (age 64.0 ± 14.8 years) were enrolled and two cases were withdrawn. The score of bladder pain was significantly reduced in both groups. However, the effect of hydrogen-rich water on symptoms was not significantly different from placebo, although the supplementation with hydrogen-rich water was extremely effective in improving VAS bladder pain score in 11 % of the patients.
In conclusion, the present study is the first clinical trial of double-blind, placebo-controlled study of hydrogen-rich water supplementation in patients with IC/PBS. The effect of hydrogen-rich water was not significantly different from the placebo control, although the supplementation with hydrogen-rich water was extremely effective in relieving VAS bladder pain in some cases. These results do not support the use of supplementation with hydrogen-rich water for treating patients with IC/PBS. An appropriately designed, large-scale, prospective clinical study would be advisable to confirm the present findings.
Seiji Matusmoto, MD, PhD as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
Asahikawa Medical University
Renal and Urological Surgery
2-1-1-1 Midorigaoka-Higashi, Asahikawa, Hokkaido 078-8510, Japan