Intravesical glycosaminoglycans in the management of chronic cystitis.

In this article we review the current status of evidence on the clinic applications of glycosaminoglycans (GAGs) in urology, with particular emphasis on the therapeutic use in all the chronic forms of cystitis. The so called "bladder layer" is mainly composed by chondroitin sulphate, dermatan sulphate and heparan sulphate. Demages of this mucus film seem to be involved in the pathogenesis of several bladder diseases. Hence, GAG replenishment therapy is widely accepted as a therapy for interstitial cystitis/ bladder pain syndrome (IC/BPS), recurrent urinary tract infections (UTIs), radiation and chemo-immunotherapy cystis and overactive bladder (OAB). A MEDLINE search from the first clinical application in 1996 allowed us to find a total of 33 works regarding the use of intravesical GAGs. Although the evidences regarding GAG replenishment therapy are very encouraging in all the forms of chronic cystitis, well-powered randomized clinical trials are needed to better comprehend the exact role of this treatment.