GLASGOW—Intravesical instillation of hyaluronic acid may be a safe and effective way to reduce the likelihood of recurrent urinary tract infections (UTIs) in fertile women, Italian investigators reported at the International Continence Society annual meeting.

Hyaluronic acid is an important constituent of bladder surface glycosaminoglycans and is a barrier of the urothelium that may help to prevent UTIs. Damage to this layer has been postulated as a causative factor in the development of recurrent UTIs, the researchers explained.

Lorenzo Rigatti, MD, and collaborators at Ospedale San Raffaele in Milan recruited 48 fertile women with recurrent cystitis, defined as at least three episodes of uncomplicated cystitis with clinical symptoms and a positive culture for each episode. The women received eight instillations (once a week for eight weeks) of hyaluronic acid (40 mg in 50 mL of a phosphate-buffered saline solution). The researchers evaluated the patients over an 18-month follow-up period.

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After the eight-week course of treatment, 36 patients (75%) were free of their disease and did not show any clinical and cultural recurrence during the 18-month follow-up. Ten patients (20.8%) had recurrence of disease during follow-up, but the mean time to recurrence increased significantly from 39.85 days before treatment to 190.64 days after treatment. Two patients (4.2%) experienced a recurrence during the eight weeks of treatment. All patients tolerated the instillations well and no serious adverse events were report.