{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T14:11:38Z","timestamp":1762956698904,"version":"3.37.3"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aktuelle Urol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n               Einleitung Die im Moment favorisierte Entstehungstheorie der\n      Interstitiellen Zystitis\/Blasenschmerzsyndrom (IC\/BPS) stellt einen Defekt der das Urothel vor\n      Urinbestandteilen isolierenden Glycosaminoclycan-Schicht in den Vordergrund. Diese\n      Polysaccharid-Schicht kann durch eine orale Therapie mit dem Heparinoid Pentosanpolysulfat\n      (PPS) restituiert werden. Die Historie der Substanz, ihre Wirksamkeit, Bewertung in Leitlinien\n      und besonders die fraglichen Zusammenh\u00e4nge mit einer Makulopathie sollen im Folgenden\n      vorgestellt werden.<\/jats:p><jats:p>\n               Methodik Literaturrecherche in PubMed und Embase<\/jats:p><jats:p>\n               Ergebnisse PPS besitzt eine US-amerikanische und europaweite\n      Zulassung zur Therapie der IC \u2013 zumeist gekn\u00fcpft an den Nachweis von Glomerulationen oder\n      einem sog. Hunner-Ulcus in der Distensionszystoskopie. In randomisierten Zulassungsstudien\n      wurde die Wirksamkeit belegt. Dies f\u00fchrte zu einer Empfehlung als Basistherapeutikum der IC\n      neben verhaltensmodulierenden, di\u00e4tetischen und medikament\u00f6s-flankierenden Ma\u00dfnahmen wie z. B.\n      einer Schmerztherapie. Nach einer sechsmonatigen Therapie soll eine Reevaluation erfolgen. Zu\n      den Nebenwirkungen geh\u00f6ren der mild blutverd\u00fcnnende Effekt, \u00dcbelkeit und Haarausfall. 2\n      Publikationen einer amerikanischen Augenklinik postulierten j\u00fcngst einen Zusammenhang einer\n      langj\u00e4hrigen, hoch dosierten Therapie mit einer bestimmten Form der retinalen Makulopathie.\n      Dieser Zusammenhang wurde in unabh\u00e4ngigen Registerstudien inzwischen widerlegt, f\u00fchrte aber\n      per Rote-Hand-Brief zu einem entsprechenden Warnhinweis in Deutschland. Aufgrund eines\n      Rechtsstreites zwischen den Kostentr\u00e4gern und dem Hersteller \u00fcber die Erstattung ist PPS in\n      Deutschland inselartig au\u00dfer Handel, jedoch weiter verordnungsf\u00e4hig und kann aus dem\n      europ\u00e4ischen Ausland reimportiert werden. Die Kosten schlagen in Deutschland mit rund 20 Euro\n      Tagestherapiekosten zu Buche. Dieser Umstand und viele Missverst\u00e4ndnisse \u00fcber die\n      Verordnungsmodalit\u00e4ten haben bedauerlicherweise zu einer Verst\u00e4rkung der schon bestehenden\n      Unterversorgung von IC-Patienten gef\u00fchrt. Es steht zu bef\u00fcrchten, dass mit zunehmender\n      Zeitdauer des laufenden Rechtsstreites diese Unterversorgung noch zunehmen wird.<\/jats:p><jats:p>\n               Fazit Als einzige kausal wirkende orale Therapieform der IC\n      besitzt PPS einen besonderen Stellenwert. Allen Besonderheiten bzgl. der\n      Verordnungsmodalit\u00e4ten und dem strittigen Zusammenhang mit einer m\u00f6glichen Makulopathie zum\n      Trotz darf PPS Betroffenen nicht vorenthalten werden.<\/jats:p>","DOI":"10.1055\/a-1629-0199","type":"journal-article","created":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T22:54:02Z","timestamp":1632869642000},"page":"556-560","source":"Crossref","is-referenced-by-count":1,"title":["Orale Therapie der Interstitiellen Zystitis: Pentosanpolysulfat-Natrium"],"prefix":"10.1055","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4960-7498","authenticated-orcid":false,"given":"Andreas","family":"Wiedemann","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Urologie, Ev. 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