Bipolar resection in combination with hyaluronic acid: a modern approach to treating lower urinary track symptoms (LUTS) in women with bladder leukoplakia

INTRODUCTION Bladder leukoplakia is a chronic condition characterized by squamous metaplasia, which can contribute to lower urinary tract symptoms (LUTS). This study investigates whether bipolar transurethral resection (TUR) combined with intravesical hyaluronic acid (HA) can enhance patient outcomes compared to TUR alone. MATERIALS AND METHODS A total of 80 female patients with bladder leukoplakia were randomized into two groups. Group A (n=40) received bipolar TUR followed by six weekly HA instillations. Group B (n=40) received only bipolar TUR. Outcomes including IPSS, quality of life (QoL), urine cultures, urinalysis, cytology, histopathology, and recurrence were assessed at baseline and 3 months postoperatively. RESULTS Group A demonstrated significantly improved IPSS and QoL scores, reduced urinary infections and cytological abnormalities, and a lower recurrence rate at 3 months. CONCLUSION Intravesical HA instillation post-TUR significantly improves short-term outcomes and reduces recurrence in women with bladder leukoplakia. KEYWORDS: bladder leukoplakia, lower urinary tract symptoms, hyaluronic acid, IPSS score