Role of oral PentosanPolysulphate in reduction of local side effects of BCG in Non muscle invasive Bladder Cancer patients: a pilot study

BACKGROUND - Intravesical immunotherapy with Bacillus Calmette-Guerin (BCG) is indicated for the treatment of high grade Ta/T1 non-muscle invasive bladder cancer (NMIBC); but it is associated with significant local side effects.

Aim of the study was to assess the role of oral Pentosan Polysulphate (PPS) in reduction of BCG related local side-effects.

METHODS - 32 symptomatic patients after BCG instillation were randomized into three groups: A, B and C. Group A received placebo (vitamin B complex tablet) in t.i.d dose, Group B received PPS 100 mg t.i.d. dose and Group C received PPS 100mg o.d and placebo (vitamin B complex tablet b.i.d dose) for 6 weeks. Visual Analog Scale (VAS) for bladder pain, Overactive Bladder-Validated 8 Question Screener (OAB-V8) and dysuria were evaluated in three groups before and during each weekly visit of BCG instillation.

RESULTS - Post treatment mean VAS score was significantly lower in Group B (4.4±1.2) and C (5.8±0.8) as compared to group A (8±0.4).Also, the post treatment VAS score was significantly lower in group B v/s group C(p<0.01). Post treatment mean OAB-V8 score was significantly decreased only in Group B (from 15.5 to 9.7).Dysuria decreased in group B and C but persisted in group A.

CONCLUSIONS - Our study demonstrates that oral PPS is effective in relieving BCG related local side effects in a (100 mg) t.i.d dose. This article is protected by copyright. All rights reserved.

BJU international. 2016 Mar 24 [Epub ahead of print]

Suresh Yadav, Vinay Tomar, Sher Singh Yadav, Shivam Priyadarshi, Indraneel Banerjee

Department of urology and Renal Transplantation, S.M.S. medical college and Hospital, Jaipur, Rajasthan, India., Department of urology and Renal Transplantation, S.M.S. medical college and Hospital, Jaipur, Rajasthan, India., Department of urology and Renal Transplantation, S.M.S. medical college and Hospital, Jaipur, Rajasthan, India., Department of urology and Renal Transplantation, S.M.S. medical college and Hospital, Jaipur, Rajasthan, India., Department of urology and Renal Transplantation, S.M.S. medical college and Hospital, Jaipur, Rajasthan, India.