Efficacy and safety of pentosan polysulfate therapy in patients with interstitial cystitis for relief of lower urinary tract symptoms: 15-year single center experience

Abstract

Background: Benefit of pentosan polysulfate sodium (PPS) for reducing chronic pain and lower urinary tract symptomin patients with interstitial cystitis/bladder pain syndrome (IC/BPS) remains inconclusive with modest effect. We aimed to evaluate the impact of PPS on improvement of lower urinary tract symptom based on the International Prostate Symptom Score (IPSS), quality of life (QoL), and uroflowmetry (UFM) in patients with IC/BPS. Materials and methods: A total of 204 patients who were prescribed oral PPS for IC/BPS from October 2006 to May 2021 were retrospectively reviewed. Patients were divided by age for treatment effect comparison. Linear mixed models were utilized to evaluate improvements in IPSS, QoL, and UFM parameters after PPS treatment. Results: There were significant gains in total IPSS (−0.335, P < 0.001) and QoL (−0.061, P < 0.001) over time, achieving stable phase within 3 months from the initiation of PPS treatment. For UFM parameters, postvoid residual decreased significantly over time (−1.052, P = 0.029), while maximum flow rate (0.093, P = 0.334) and voiding volume (0.751, P = 0.586) showed no significant differences. Compared to patients older than 65 years, those younger than 65 years showed significantly better improvements in the IPSS (−0.492 vs. −0.184, P = 0.018) but worse in voiding volume (−2.481 vs. 5.032, P = 0.006). Conclusions: PPS provides clinical benefits in urinary symptoms voiding symptoms and QoL over time, arriving plateau within 3 months. Such benefits based on the IPSS tend to be more evident in younger patients, suggesting that PPS mostly benefits early treatment if suspected for IC/BPS.