Objective: The article presents a review of modern literature on the problem of chronic diseases of the bladder, including painful bladder syndrome/interstitial cystitis, recurrent lower urinary tract infection, chemical or radiation cystitis, the pathogenesis of which is associated with the same pathophysiological changes.
Material: The first step in the development of these diseases is associated with the loss of glycosaminoglycans (GAGs) in the mucous membrane of the bladder. The glycosaminoglycan layer consists of negatively charged polysaccharides. The GAG layer binds water, turning it into a gel, using a process known as electrostatic capture. As a result, a buffer is formed between the toxic components of urine and urothelial cells. The GAG thin line acts as a non-specific release factor and non-specific defense mechanism against infection and substances in the urine (for example, urea and potassium). The analysis of modern studies that confirm a decrease in the rate of relapse of urinary tract infections (UTI) due to the replenishment of the GAG line is presented.
Results: A significant decrease in the level of UTI in the patient was shown, both in the number of exacerbations per year and in the increase in the average time to relapse aer intravesical instillations of glucuronic acid preparations in women with recurrent UTI. Conclusion: Hyaluronic acid and chondroitin sulfate with intravesical instillations were effective in reducing the frequency of urination and pain in patients with interstitial cystitis.
For citation: Perepanova T.S., Khazan P.L., Kazachenko A.V., Malova Yu.A. Intravesical replacement of glycosaminoglycans in patient management with cystitis. Experimentalnaia and Clinicheskaia Urologia 2019;(3):110-117