O'Hollaren Kyle, Considine Jack, Radoiu Codrut, Madan Raghav, Liaw Aron, Dhar Nivedita
Wayne State University School of Medicine, Detroit, MI, USA.
John D. Dingell VA Medical Center, 4646 John R Street, Detroit, MI, 48201, USA.
Int Urol Nephrol. 2025 Mar;57(3):753-758. doi: 10.1007/s11255-024-04251-x. Epub 2024 Oct 23.
Intravesical application of birth tissue has been reported to inhibit inflammation, alleviate collagen fiber accumulation, and enhance bladder tissue generation. We have previously reported that intra-detrusor micronized amnion monolayer (AM) injections provide short-term clinical improvement in refractory IC/BPS patients. Herein, we evaluate the therapeutic responses and adverse events of micronized amnion/chorion bilayer (AC) in patients with refractory IC/BPS with 6 months follow-up.
Fifteen patients affected by IC/BPS who failed conventional therapy received 100 mg of reconstituted micronized AC was injected intra-detrusor via cystoscopy under general anesthesia, using a 23-gauge needle. Twenty 0.5-mL injections were administered into the lateral and posterior bladder walls, avoiding the dome and trigone. Changes in interstitial cystitis symptom index (ICSI), Interstitial cystitis problem index (ICPI), Bladder pain/ interstitial cystitis symptom score (BPIC-SS) and Overactive Bladder Assessment Tool (OAB), from baseline to 6 months post-injection were evaluated retrospectively. The safety of injections was analyzed.
Fifteen total refractory IC/BPS patients with an average age of 41.1 ± 14.5 years were included in the study, receiving intra-detrusor injections of 100 mg of micronized AC. One month after injections, significant improvement in IC/BPS symptom scores was noted in all patients. All patients maintained a sustained clinical response at 6 months post-injection. No product-related adverse events were observed.
Our findings indicate that the AC formulation significantly reduces time to symptom relief in patients with refractory interstitial cystitis/bladder pain syndrome (IC/BPS) and maintains a sustained response up to 6 months post-injection. These results suggest a promising clinical benefit of using an amnion/chorion bilayer product for treating IC/BPS. Further research is needed to confirm these findings and assess the long-term durability of this treatment approach. This study represents the first evidence supporting the clinical advantages of an amnion/chorion bilayer product in managing IC/BPS.
据报道,膀胱内应用出生组织可抑制炎症、减轻胶原纤维堆积并促进膀胱组织生成。我们之前曾报道,膀胱逼尿肌内注射微粉化羊膜单层(AM)可为难治性间质性膀胱炎/膀胱疼痛综合征(IC/BPS)患者带来短期临床改善。在此,我们对难治性IC/BPS患者进行了6个月随访,以评估微粉化羊膜/绒毛膜双层(AC)的治疗反应和不良事件。
15例接受传统治疗无效的IC/BPS患者在全身麻醉下通过膀胱镜检查,使用23号针头将100mg复溶的微粉化AC注射到膀胱逼尿肌内。在膀胱侧壁和后壁进行20次0.5mL注射,避开膀胱顶部和三角区。回顾性评估从基线到注射后6个月期间,间质性膀胱炎症状指数(ICSI)、间质性膀胱炎问题指数(ICPI)、膀胱疼痛/间质性膀胱炎症状评分(BPIC-SS)和膀胱过度活动症评估工具(OAB)的变化。分析注射的安全性。
本研究共纳入15例难治性IC/BPS患者,平均年龄41.1±14.5岁,接受了100mg微粉化AC的膀胱逼尿肌内注射。注射后1个月,所有患者的IC/BPS症状评分均有显著改善。所有患者在注射后6个月均维持了持续的临床反应。未观察到与产品相关的不良事件。
我们的研究结果表明,AC制剂可显著缩短难治性间质性膀胱炎/膀胱疼痛综合征(IC/BPS)患者的症状缓解时间,并在注射后6个月内维持持续反应。这些结果表明,使用羊膜/绒毛膜双层产品治疗IC/BPS具有良好的临床益处。需要进一步研究来证实这些发现并评估这种治疗方法的长期有效性。本研究是支持羊膜/绒毛膜双层产品在治疗IC/BPS方面临床优势的首个证据。