Intravesical Injection of Dextrose to Improve Lower Urinary Tract Symptoms Caused by Chronic Cystitis
Status:
Completed
Trial end date:
2020-10-11
Target enrollment:
Participant gender:
Summary
The pathogenesis of bladder pain syndrome/interstitial cystitis (BPS/IC) is currently
unclear. Scholars have put forward different hypotheses, including the function of the
extracellular matrix surface of the glycosaminoglycan (GAG) layer, downregulation of tight
junction protein, increased urothelial permeability, mast cell activation, neurogenic
inflammation, and psychosomatic factors. The symptoms are very similar to severe bladder pain
syndrome/interstitial cystitis, and the patients respond to existing medications. In 1956,
Dr. George Hackett created a method for treating damaged ligaments and tendons called
prolotherapy (proliferation therapy). Prolotherapy is defined as an alternative therapy for
musculoskeletal and arthritic pain, including the treatment of irritating substances (such as
dextrose, also known as d-glucose) injected into ligaments or tendons to promote the growth
of new tissues. There are many clinical trials confirming that proliferation therapy can
effectively treat painful musculoskeletal problems. For example, in patients with lateral
epicondylitis treated with a solution with a final concentration of 10% dextrose, compared
with patients treated with placebo (normal saline), pain and isometric muscle strength
improved significantly. A recent literature review also tells that hypertonic glucose
proliferation therapy can effectively treat a variety of musculoskeletal diseases.
Hence, this research suggests that dextrose prolotherapy is an affordable and effective pain
management strategy in dealing with musculoskeletal neuroinflammation pain in BPS/IC. In
order to begin to understand prolotherapy and its therapeutic utility, this study should
begin to elucidate the immediate response of prolotherapy in the urology field by
investigating the impact of dextrose.
This project is expected to accommodate subjects with BPS/IC, by injecting 10% dextrose into
the bladder lining muscles of IC patients and performing various urodynamic tests and
questionnaires to evaluate the patient's urinary voiding symptoms and urinary bladder
function recovery. Afterward, the expressions of growth factors and cytokines in the urine
samples were investigated in an attempt to reveal the mechanism of dextrose prolotherapy in
BPS/IC disease.