Changes in Sexual Function of Women with Refractory Interstitial Cystitis/Bladder Pain Syndrome after Intravesical Therapy with a Hyaluronic Acid Solution

IntroductionIntravesical instillation with a hyaluronic acid (HA) solution is an effective treatment for interstitial cystitis/bladder pain syndrome (IC/BPS), but its impact on sexual functioning of patients is not known.AimThe aim of this study was to evaluate the changes in sexual function of women with refractory IC/BPS who underwent a second‐line intravesical HA therapy.MethodsA total of 103 women diagnosed with refractory IC/BPS were enrolled in this prospective, multicenter study. Sexual function was evaluated using the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ‐9). Bladder‐related symptoms and bother were assessed by the Interstitial Cystitis Symptom Index (ICSI) and Interstitial Cystitis Problem Index (ICPI), and a pain visual analog scale (VAS), respectively. Data were analyzed with univariate methods or multivariate logistic regression analysis accordingly.Main Outcomes MeasuresChanges in PISQ‐9, ICSI, ICPI, and pain VAS scores after treatment were assessed.ResultsMean age and duration of symptoms was 43.6 ± 11.8 and 5.1 ± 5.0 years, respectively. ICSI, ICPI, and pain VAS scores were significantly (P < 0.001) improved after 1 month and 6 months of treatment. Of the 87 (84.5%) sexually active women evaluated, PISQ‐9 total scores improved significantly (P < 0.001) from the baseline (mean 18.9 ± 6.4), after 1 month (20.4 ± 5.8), and 6‐months (21.5 ± 5.6) of treatment. Significantly improved PISQ‐9 items included “dyspareunia” (P < 0.001) and “negative reactions” (P = 0.015) during sexual intercourse, and “intensity” (P < 0.001) of sexual orgasms. After a logistic regression analysis, we found that a baseline PISQ‐9 score was negatively correlated with the duration of IC/BPS symptoms (P = 0.022). Meanwhile, the changes in PISQ‐9 scores were positively correlated with the reduction in ICSI scores after treatment (P = 0.045).ConclusionsIntravesical HA is an effective treatment for refractory IC/BPS. A longer duration of IC/BPS symptoms may be a predictor of poor sexual function. However, intravesical HA may improve sexual function along with the reduction of IC/BPS symptoms. Hung MJ, Su TH, Lin YH, Huang WC, Lin TY, Hsu CS, Chuang FC, Tsai CP, Shen PS, and Chen GD. Changes in sexual function of women with refractory interstitial cystitis/bladder pain syndrome after intravesical therapy with a hyaluronic acid solution. J Sex Med 2014;11:2256–2263.