Self-Administered Intravesical Hyaluronic Acid Improves Symptoms and Quality of Life in a Patient-Centred Approach To Bladder Pain Syndrome Management
Bibliographic record
Abstract
Background and Objectives Bladder pain syndrome (BPS) is an uncommon and potentially debilitating spectrum of chronic pain typically accompanied by lower urinary tract symptoms. Intravesical hyaluronic acid (HA) is a commonly used treatment option, but requires multiple follow-up clinic appointments. We introduced a novel patient-led ‘at-home’ pathway of self-administered HA treatment to reduce the number hospital visits required by patients. We assessed and compared patient-reported outcome measures (PROMS) from patients receiving nurse-administered ‘in-hospital’ and patient-led self-administered ‘at-home’ intravesical HA (Cystistat® and Hyacyst®, respectively). Secondary outcome measures included differences between waiting times for treatment, frequency of treatments, number of clinician and nurse clinic appointments, and estimated financial costs. Patients and Methods Sixty consecutive patients commencing intravesical HA for BPS symptoms between 1 st January 2016 and 31 st March 2019 were included. O’Leary-Sant Interstitial Cystitis Symptom Index questionnaires were completed prior to, and following, six treatments. Relevant clinical and demographic data were also collected. Results Overall, 76.6% of the patients had improvement in symptoms after HA treatment. Mean O’Leary-Sant questionnaire symptom and problem scores were significantly improved following HA treatment (11.8 (range 6–17) to 8.5 (range 4–13) (p=0.00005) and 11.4 (range 4–16) to 7.9 (range 4–14) (p=0.0002), respectively. There were no significant differences in symptom improvements between patients on either pathway. Mean waiting time for treatment and number of treatments were lower in the patient-led pathway, and number of hospital visits was significantly lower in the patient-led at home pathway. The patient-led pathway could ‘save’ approximately 76 nurse clinic and 11 outpatient clinic appointments per year, and confer cost-savings of more than £1,500 per patient, per year. Conclusions Our case series analyses suggest that patient-led ‘at-home’ intravesical HA administration (Hyacyst®) is acceptable to patients and confers similar symptomatic benefit to ‘in-hospital’ nurse-led HA (Cystistat®). In addition, it appears that BPS sufferers established on the patient-led pathway require fewer HA treatments and fewer hospital visits, and as such, the patient-led pathway may also confer financial cost savings, and relieve some pressures on clinic appointment availability.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".