{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:40:19Z","timestamp":1792428019047,"version":"4.5.0"},"reference-count":89,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T00:00:00Z","timestamp":1761436800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically summarise and meta\u2010analyse all uncontrolled and controlled studies evaluating the role of intravesical instillation of hyaluronic acid (HA), with or without chondroitin sulphate (ChS), in the treatment of bladder pain syndrome (BPS), recurrent urinary tract infection (rUTI) and post\u2010radiation cystitis (pRC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review was conducted, and a protocol was registered with PROSPERO (CRD42025640480). Studies published between 1 January 1969 and 31 August 2024 were retrieved from multiple databases. Data were analysed using random\u2010effects and common\u2010effects models with subgroup and sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 131 studies were retrieved, of which 30, 10 and three investigated the use of HA\/ChS in patients with BPS and rUTI or pRC, respectively, and were included in the analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The use of HA\/ChS resulted in a significant improvement in pain as well as voiding and irritative symptoms in all the investigated conditions. In addition, the treatment reduced the risk of rUTI when compared to standard care. Although limited data were available, when randomised controlled trials were investigated, the combined use of HA\/ChS resulted in better outcomes and a lower infection rate compared to either placebo or standard of care (odds ratio\u20090.42 [95% CI 0.25; 0.49];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Finally, an improvement in sexual function and quality of life was also observed.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.70016","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:44:51Z","timestamp":1761525891000},"page":"36-48","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Hyaluronic acid and chondroitin sulphate instillation in chronic bladder diseases: a meta\u2010analysis"],"prefix":"10.1111","volume":"137","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9894-2885","authenticated-orcid":false,"given":"Giovanni","family":"Corona","sequence":"first","affiliation":[{"name":"Endocrinology Unit Azienda AUSL Bologna, Ospedale Maggiore  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2347-9504","authenticated-orcid":false,"given":"Paolo","family":"Capogrosso","sequence":"additional","affiliation":[{"name":"Department of Urology and Andrology Ospedale di Circolo and Macchi Foundation  Varese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Baldini","sequence":"additional","affiliation":[{"name":"Department of Urology and Andrology Ospedale di Circolo and Macchi Foundation  Varese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Rastrelli","sequence":"additional","affiliation":[{"name":"Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental, Clinical, and Biomedical Sciences \u2018Mario Serio\u2019 University of Florence  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Vignozzi","sequence":"additional","affiliation":[{"name":"Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental, Clinical, and Biomedical Sciences \u2018Mario Serio\u2019 University of Florence  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0666-5105","authenticated-orcid":false,"given":"Javier","family":"Romero\u2010Otero","sequence":"additional","affiliation":[{"name":"Department of Urology Hospital Universitario HM Sanchinarro, HM Hospitales and ROC Clinic  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0595-7165","authenticated-orcid":false,"given":"Andrea","family":"Salonia","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology URI, IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1513-6360","authenticated-orcid":false,"given":"Yacow","family":"Reisman","sequence":"additional","affiliation":[{"name":"Amstelland Hospital  Amstelveen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Bettocchi","sequence":"additional","affiliation":[{"name":"Andrology and Male Genitalia Reconstructive Surgery Unit University of Foggia  Foggia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Maggi","sequence":"additional","affiliation":[{"name":"Endocrinology Unit, \u2018Mario Serio\u2019 Department of Experimental and Clinical Biomedical Sciences University of Florence  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8963-4581","authenticated-orcid":false,"given":"Mikkel","family":"Fode","sequence":"additional","affiliation":[{"name":"Department of Urology Copenhagen University Hospital, Herlev and Gentofte Hospital  Herlev Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,26]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00182044"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40122-023-00559-1"},{"key":"e_1_2_7_4_1","unstructured":"EngelerDBA BerghmansB BirchJet\u00a0al.EAU guidelines on chronic pelvic pain. 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