# Impact of Elmiron adjunct therapy on outcomes of fulguration in chronic interstitial cystitis in women

## TL;DR

Adding Elmiron to bladder fulguration improves long-term symptoms in women with Hunner-type interstitial cystitis, though pain levels remain unchanged.

## Contribution

This study is the first to systematically evaluate Elmiron as an adjunct to fulguration for Hunner-type IC.

## Key findings

- Elmiron group showed significantly greater reduction in ICSI scores at 12 months.
- ICPI scores improved more in the Elmiron group at both 6 and 12 months.
- No significant difference in VAS scores between groups at any time point.

## Abstract

Interstitial cystitis (IC), particularly in patients with Hunner-type lesions, is a chronic, debilitating condition with limited treatment success. While bladder fulguration and pentosan polysulfate sodium (PPS, Elmiron) are established treatments, their combined efficacy has not been systematically studied.

To evaluate whether adjunctive Elmiron therapy enhances the therapeutic outcomes of fulguration in female patients with Hunner-type IC.

A total of 97 female patients with Hunner-type IC who underwent bladder fulguration between 2022 and 2024 were included in this retrospective analysis of prospectively collected data. Group 1 (n = 49) received Elmiron therapy for 6 months postoperatively, while Group 2 (n = 48) did not. Patients were followed for 12 months, and outcomes were assessed using the Visual Analogue Scale (VAS), Interstitial Cystitis Symptom Index (ICSI), and Interstitial Cystitis Problem Index (ICPI).

No statistically significant differences were observed between groups in VAS scores at any time point. However, Group 1 showed a significantly greater reduction in ICSI scores at 12 months (p = 0.023) and in ICPI scores at both 6 months (p = 0.040) and 12 months (p < 0.001). Percentage change analyses confirmed a more pronounced improvement in symptom and problem indices in the Elmiron group at 12 months.

Adjunctive Elmiron therapy appears to enhance the long-term symptom and problem index outcomes of fulguration in women with Hunner-type interstitial cystitis. Further large-scale, multicenter studies are warranted to optimize treatment protocols and establish standardized guidelines for this combination approach.

The online version contains supplementary material available at 10.1186/s12894-026-02057-w.