The efficacy and safety of intravesical platelet-rich plasma injections into the bladder for the treatment of interstitial cystitis/bladder pain syndrome: a systematic review and meta-analysis.

Abstract

Introduction: Interstitial cystitis/bladder pain syndrome is a chronic bladder condition with a rising incidence that significantly impacts the lives of millions worldwide. The lack of understanding regarding the pathophysiology of this condition has resulted in a deficiency of effective treatment options. However, the development of regenerative medicine has brought platelet-rich plasma into our field of vision. Platelet-rich plasma may address unresolved inflammation in the interstitial cystitis/bladder pain syndrome bladder and facilitate the restoration of bladder and urethral barrier function through repeated injections, potentially reducing bladder pain. Our aim is to investigate the efficacy and safety of intravesical injection of platelet rich plasma in the treatment of interstitial cystitis/bladder pain syndrome.

Evidence acquisition: A comprehensive search was conducted across PubMed, EMBASE, MEDLINE, Cochrane Library, and Web of Science databases for studies on platelet-rich plasma injection for the treatment of interstitial cystitis/bladder pain syndrome, with a search cutoff date of August 7, 2024.

Evidence synthesis: A total of 11 studies with 391 participants were included. The combined statistics indicated that the baseline interstitial cystitis symptom index score was 11.20±4.60, the interstitial cystitis problem index score was 10.81±3.51, and the pain score was 4.37±3.14. The results showed that compared to pre-treatment, the interstitial cystitis symptom index score decreased by 3.56 (95% CI -4.39 to -2.72, P<0.00001), the interstitial cystitis problem index score decreased by 3.24 (95% CI -3.90 to -2.58, P<0.00001), and the pain score decreased by 1.84 (95% CI -2.19 to -1.48, P<0.00001). Additionally, the average proportion of patients with a global response assessment score of ≥2 after treatment was 48% (95% CI 0.37 to 0.58, P<0.00001). Furthermore, the overall incidence of adverse events among patients was 2.9%.

Conclusions: Evidence-based statistical analysis results suggest that intravesical platelet-rich plasma treatment is effective and safe, potentially serving as a promising approach for managing interstitial cystitis/bladder pain syndrome.