N 6 (197) 2025. P. 55–60

CLINICAL MONITORING OF REFRACTORY INTERSTITIAL CYSTITIS DURING PHARMACOTHERAPY IN WOMEN

K. Ye. Vydrin, V. O. Poliakov, F. I. Kostev, Yu. M. Dekhtiar, M. V. Shostak

Odesa National Medical University, Odesa, Ukraine

DOI 10.32782/2226-2008-2025-6-8

Refractory interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic condition marked by resistance to standard treatments and persistent symptoms such as pelvic pain, urgency, frequency, and reduced bladder capacity.

Objective – to improve treatment outcomes in women with refractory IC/BPS by using a personalized multimodal approach combining intravesical botulinum toxin type A (BTA), gabapentin, and hydroxychloroquine.

Materials and methods. A prospective study included 67 women diagnosed with refractory IC/BPS. Patients were assigned to two groups: the control group (n=32) received intravesical BTA alone, while the main group (n=35) received the combination therapy. Treatment lasted 6 months, with follow-up for 12 months. Efficacy was evaluated using O’Leary-Sant questionnaires, VAS for pain, urinary diaries, and cystoscopy.

Results. Combination therapy showed superior efficacy over BTA monotherapy. In 6 months, 80% of patients in the main group reported good/satisfactory outcomes vs. 53.1% in the control group. At 12 months, Hunner’s ulcers were observed in 22.85% of the main group vs. 59.37% of the control group (p < 0.001); glomerulations occurred in 40% vs. 87.5% (p < 0.001). Functional bladder capacity improved by 99.05%. Pain (VAS) decreased by 68.3%, urinary frequency by 54.6%, urgency by 76.1%, nocturia by 69.7%, and ICSI/ICPI scores by 70% and 65.9%, respectively (p < 0.05).

Conclusion. The combination therapy offers better symptom control, improved urothelial healing, and sustained results compared to BTA monotherapy.

Key words: interstitial cystitis, bladder pain syndrome, botulinum toxin, gabapentin, hydroxychloroquine.

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