ArticleInternational urogynecology journal2026
Intravesical HA/EGF Salvage Therapy for Hyaluronic Acid-Refractory Interstitial Cystitis/Bladder Pain Syndrome: A Small Retrospective Pilot Case Series.
Article in International urogynecology journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introduction and hypothesisSome patients with interstitial cystitis/bladder pain syndrome (IC/BPS) remain symptomatic despite prolonged intravesical hyaluronic acid (HA). We report a small retrospective pilot case series evaluating HA plus epidermal growth factor (HA/EGF) as salvage therapy in selected HA-refractory patients.
methodsHA nonresponders were identified from a multicenter routine-care IC/BPS program. Nonresponse was defined as Global Response Assessment (GRA) < +2 after at least 2 years of HA instillation. Patients electing HA/EGF received eight instillations over 6 months. Outcomes included pain visual analog scale (Pain-VAS), diary variables, Interstitial Cystitis Symptom Index/Problem Index (ICSI/ICPI), GRA, European Society for the Study of Interstitial Cystitis (ESSIC) grade, cystoscopic bladder capacity, and early treatment intolerance. Within-patient changes were analyzed using paired tests. Composite salvage success required ≥ 50% Pain-VAS reduction, ≥ 50-mL functional bladder capacity increase, and ≥ 50% nocturia reduction.
resultsTwelve women initiated HA/EGF and 11 completed 6 months. Pain-VAS decreased by 6.7 ± 1.8 points and functional bladder capacity increased by 106 ± 41 mL (both p < 0.001). Daytime frequency and nocturia decreased by 5.6 and 3.1 episodes (both p < 0.01), and ICSI/ICPI improved (both p < 0.001). Cystoscopic improvement occurred in 8/11 (73%), and composite salvage success in 9/11 (82%). Severe early dysuria occurred in 2/12, with one patient discontinuing treatment. No serious procedure-related adverse events were recorded.
conclusionsHA/EGF was associated with clinical, voiding, and cystoscopic improvements and acceptable short-term tolerability in selected HA-refractory IC/BPS patients. These preliminary findings are hypothesis-generating and require prospective controlled validation.
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