Intravesical hyaluronic acid with chondroitin sulphate to prevent urinary tract infection after spinal cord injury

The Journal of Spinal Cord Medicine, 2023 · DOI: 10.1080/10790268.2022.2089816 · Published: June 28, 2022

Simple Explanation

This study explores if a bladder treatment, using hyaluronic acid and chondroitin sulphate (HA+CS), can help prevent urinary tract infections (UTIs) in people with spinal cord injuries (SCI). The treatment involves putting HA+CS directly into the bladder through a catheter. The study looked at two groups: people with recent SCIs (acute) and those with long-term SCIs (chronic). The goal was to see if the treatment was safe and easy to use in both groups. Researchers found that the treatment was safe, with only minor side effects like cloudy urine. Recruiting people with recent SCIs was harder, but those with long-term SCIs were eager to try the treatment to reduce UTIs.

Study Duration

24 weeks

Participants

10 participants: 2 with acute SCI, 8 with chronic SCI

Evidence Level

Not specified

Key Findings

1
HA+CS was well tolerated by participants with spinal cord injury.
2
Recruitment was more difficult in early acute SCI.
3
Participants with chronic SCI were highly motivated to reduce UTI and manage self-administration without difficulty.

Research Summary

This study investigated the safety and feasibility of intravesical hyaluronic acid with chondroitin sulphate (HA+CS) instillations in preventing urinary tract infections (UTIs) in patients with acute and chronic spinal cord injury (SCI). The study found that HA+CS was well tolerated, with mild and short-lived side effects. However, recruitment of acute SCI patients was challenging compared to chronic SCI patients. The researchers suggest that larger trials are warranted to evaluate the efficacy of HA+CS in preventing UTIs in patients with neurogenic bladder from SCI.

Practical Implications

Potential UTI Prevention

Intravesical HA+CS may be a feasible option for preventing UTIs in individuals with SCI, particularly those with chronic SCI.

Self-Administration Feasibility

The study suggests that individuals can self-administer HA+CS at home after initial education, improving accessibility.

Future Research

Larger, placebo-controlled trials are needed to confirm the efficacy of HA+CS in preventing UTIs in this population.

Study Limitations

1
Small sample size, limiting the ability to draw definitive conclusions about efficacy.
2
Difficulties in recruiting acute SCI patients, potentially skewing the results.
3
Lack of a placebo control group, making it difficult to differentiate the effects of HA+CS from a placebo effect.

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