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Intravesical hyaluronic acid and chondroitin sulfate for recurrent urinary tract
infections: systematic review and meta-analysis
#MMPMID29181550
Goddard JC
; Janssen DAW
Int Urogynecol J
2018[Jul]; 29
(7
): 933-942
PMID29181550
show ga
INTRODUCTION AND HYPOTHESIS: The objective was to assess the efficacy of
intravesical hyaluronic acid (HA) and chondroitin sulfate (CS), alone or in
combination, for recurrent urinary tract infections (RUTIs) in adult female
patients using a systematic review and meta-analysis. METHODS: English-language
articles were obtained from the MEDLINE, Embase, and Cochrane databases through
November 2016, by manual searching and cross-referencing. Randomized and
nonrandomized trials of adult female patients with a documented history of RUTIs
who received HA, CS or HA plus CS were included. The random effects model was
applied to all pooled analyses. Risk of bias was assessed for individual studies
and across studies. RESULTS: Two randomized (n = 85) and six nonrandomized
(n = 715) studies met the inclusion criteria. These studies assessed HA ± CS;
studies of CS alone were not identified in the search. HA ± CS decreased the UTI
rate per patient-year (pooled mean difference [MD] -2.56; 95% confidence interval
[CI] -3.86, -1.26; p < 0.001) and increased the time to first UTI recurrence
(pooled MD 130.05 days; 95% CI 5.84, 254.26; p = 0.04). There was heterogeneity
in most outcomes considered, and publication bias in many studies. The standard
of trial reporting was low. The patient population size, and the number of
studies included, were small. CONCLUSIONS: HA ± CS appears to reduce the rate of
UTI and increase the time to recurrence in women with RUTI. As randomized
controlled studies are available only for HA plus CS, the quality of evidence is
higher for the combination than for HA alone.
|Administration, Intravesical
[MESH]
|Adult
[MESH]
|Chondroitin Sulfates/*administration & dosage/therapeutic use
[MESH]
|Female
[MESH]
|Humans
[MESH]
|Hyaluronic Acid/*administration & dosage/therapeutic use
[MESH]
free
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