PROPHYLACTIC BLADDER INSTILLATIONS WITH IALURIL (R) MAY REDUCE SYMPTOMS OF ACUTE RADIATION CYSTITIS IN PATIENTS UNDERGOING RADIOTHERAPY FOR PELVIC TUMOURS

Introduction: Acute radiation cystitis (RC) is a common and debilitating problem in patients undergoing radiotherapy for urogenital malignancies. Acute RC symptoms include painful micturition, urgency, frequency, and nicturia We studied the feasibility and efficacy of intravesical instillations with Ialuril® (sodium hyaluronate and chondroitin sulfate sterile solution) to reduce acute radiation cystitis in men and women undergoing pelvic radiotherapy. Materials and Methods: The single-arm study was performed between September 2010 and June 2011 and included 15 patients who met the following criteria: primary or adjuvant radiotherapy for pelvic cancer. Exclusion criteria were: bladder cancer, LUTS, overactive bladder syndrome. Symptoms of haematuria, frequency of voiding and the visual analogue scale of pelvic pain (range 0- 10) were evaluated before and after the treatment with followup of 6 months. During radiotherapy, all patients received weekly bladder instillations of 50 ml of sterile sodium HA 1.6% and CS 2.0% solution (IALURIL®). Results: A reduction of degree symptoms of haematuria occurred in 13 of 15 patients (p<0.001). reduction of frequency of voiding and of visual analogue scale score were significantly lower than baseline at the 6-months (p<0.001, p 0.002, respectively). Discussion and Conclusion: Bladder instillations with Ialuril® seems to reduce acute post-irradiation cystitis symptoms in patients treated for pelvic malignancies. Further studies are needed to obtain more robust evidence.