The use of intravesical hyaluronic acid for recurrent urinary tract infections in children: a case-series study

Background: This is the first study performed to evaluate the effects of intravesical hyaluronic acid (IHA) instillation on diminishing the frequency of recurrent urinary tract infections (UTIs) in children. Methods: Fifteen children (10 girls, 5 boys) with recurrent UTIs were divided into two groups as either complicated (group 1) (with accompanying disorders including vesicoureteral reflux or neurogenic bladder) or uncomplicated patients (group 2). After administration of weekly four sessions of IHA therapy the patients were followed-up monthly for 2 years and classified as responsive (complete/partial) or unresponsive to treatment. Results: 53.3% of the patients with recurrent UTIs were complicated. In group 1 (n=8), complete and partial response rates were 62.5% (n=5) and 25% (n=2), respectively. There was no response in 12.5% (n=1) of the cases in group 1. In group 2 (n=7), complete and partial response rates were 71.4% (n=5) and 14.3% (n=1), respectively. In this group, 14.3% (n=1) of the patients were found to be unresponsive to IHA treatment. No side effects were observed in any of the patients. Conclusions: IHA administration is considered as an effective treatment modality which significantly reduces the prevalence of or even provides complete recovery from recurrent UTIs in childhood. Therefore, it is believed that this approach can be used as a promising alternative to widespread use of antibiotics in this patient group.