Outcome of combined triamcinolone and platelet-rich plasma injection in treatment of patients with interstitial cystitis/bladder pain syndrome.

PURPOSE: Treatment of interstitial cystitis/bladder pain syndrome (IC/BPS) often lacks durable efficacy. Intravesical platelet-rich plasma (PRP) achieves > 50% success rates, but some patients remain refractory. This study evaluated the outcome of combined triamcinolone and PRP in patients with suboptimal response to prior PRP therapy. METHODS: Sixty-two patients with IC/BPS and inadequate response (global response assessment [GRA] <2) to previous PRP injections at least 3 months earlier were included. All patients received four monthly intravesical injections of PRP combined with 40 mg triamcinolone. Changes in symptom scores and uroflowmetry parameters were assessed from baseline to 3 and 6 months after treatment and compared with prior post-PRP treatment outcomes. RESULTS: The cohort included 15 patients with Hunner's IC (HIC) and 47 with non-Hunner's IC (NHIC). After treatment, symptom scores and bladder pain improved significantly, with 33 patients (53.2%) achieving GRA ≥2 at 3 months and 38 (61.3%) at 6 months after completion of combined treatment. Compared with prior PRP post-treatment outcome, combined therapy resulted in greater symptom improvement. Patients with NHIC and HIC demonstrated similar treatment outcome and reductions in bladder pain. Within the NHIC subgroup, patients with different cystoscopic hydrodistention findings at baseline showed similar symptomatic improvement with combined therapy. However, patients with a higher baseline bladder pain score (visual analog score ≥5) had a less favorable GRA at 3 months. CONCLUSION: Combined PRP and triamcinolone intravesical injections achieved a satisfactory treatment outcome in 61.3% of patients with IC/BPS who were refractory to previous PRP treatment, suggesting a potential role for adjunctive steroid therapy targeting inflammation.