#0595

Revealing Distinct Treatment Mechanisms and Outcome Correlations in Patients with Interstitial Cystitis/Bladder Pain Syndrome After Different Bladder Therapies Through Urinary Biomarker Analysis

C. Yang¹, Y. Chiu², P. Tsai², J. Jhang¹, H. Kuo¹

¹Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
²Department of Medical Education, Medical Administration Office, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan

Introduction:

Urinary cytokine changes may serve as biomarkers to assess treatment outcomes for interstitial cystitis/bladder pain syndrome (IC/BPS). This study analyzed the changes in urinary cytokines following various bladder therapies and explored their clinical significance in therapeutic mechanisms.

Material and methods:

A total of 122 patients with IC/BPS treated with platelet-rich plasma (PRP), botulinum toxin-A (BoTN-A), hyaluronic acid (HA), or low-energy shock wave (LESW) were evaluated. Urinary inflammatory and oxidative stress biomarkers were measured at baseline and at 3 months posttreatment. Treatment outcomes were assessed using the Global Response Assessment (GRA), a 10-point visual analog score for pain, and the O'Leary–Saint Symptom Score (OSS). A GRA ≥2 was considered indicative of effective treatment.

Results:

Significant symptom improvement was observed in patients treated with PRP and BoNT-A but not with LESW or HA. At 3 months post-treatment, PRP therapy led to decreased urinary 8-isoprostane and total antioxidant capacity levels, while BoNT-A therapy reduced monocyte chemotactic protein-1 and 8-hydroxy-2′-deoxyguanosine levels. HA therapy did not alter urinary biomarker levels, whereas LESW therapy increased macrophage inflammatory protein-1 beta and tumor necrosis factor-α levels. Patients with significant urinary biomarker reductions (GRA ≥2) demonstrated clinical improvement at 3 months.