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Recent Trial Fails to Effectively Compare DMSO and Chondroitin Sulphate 2% Bladder Instillations for IC/PBS

Tutolo, Manuela, Ammirati, Enrico, Castagna, Giulia, Klockaerts, Katrien, Plancke, Hendrik, Ost, Dieter, Aa, Frank Van der, & Ridder, Dirk De. (2017). A prospective randomized controlled multicentre trial comparing intravesical DMSO and chondroïtin sulphate 2% for painful bladder syndrome/interstitial cystitis. International braz j urol, 43(1), 134-141.

While dimethyl sulphoxide (DMSO) remains the only bladder instillation medication approved by the U.S. Food and Drug Administration for interstitial cystitis/painful bladder syndrome (IC/PBS), chondroitin sulphate bladder instillations have been approved in both Canada and Europe for use in the treatment of IC/PBS. Both medications seem to have an important role in the repair of the glycosaminoglycan (GAG) layer of the bladder, which is often damaged or deteriorated in IC patients. Previous studies have shown patient improvement with the use of chondroitin sulphate bladder instillations, but no study has been able to demonstrate statistical significance to support its use. This most recent trial aimed to compare the use of DMSO vs. chondroitin sulphate for bladder instillation treatment, but it was discontinued before completion due to a high withdrawal rate from the study as a result of intolerable side effects from DMSO. The most common side effects were pain and dysuria, and a less common but bothersome side effect was a strong garlicky body odor for up to seven hours post-instillation. Before the trial was discontinued, however, patients receiving chondroitin sulphate 2% showed improvement in pain reduction and nighttime frequency of urination. The use of chondroitin sulphate 2% also demonstrated minimal side effects. This trial demonstrates potential for the use of chrondroitin sulphate in bladder instillations, but further research, especially in comparison to other bladder instillation options, is needed.

—By Christina Hicks
Christina Hicks, MS, APRN, WHNP-BC, is a women’s health nurse practitioner in urogynecology with a special interest in interstitial cystitis, chronic pelvic pain, and women’s sexual health. She lives in Dallas, Texas.