**2. Results**

Among the 56 female patients included in the study, 30 received four monthly PRP injections and 26 received a single BoNT-A injection. Patients' baseline demographics, including symptom score, voiding diary data, uroflowmetry data, findings of cystoscopic hydrodistention, and duration of IC/BPS symptoms are listed in Table 1. There was no significant difference between the two treatment groups; however, a higher VAS score for bladder pain was perceived at baseline in the BoNT-A group.

**Table 1.** Baseline demographics of patients with interstitial cystitis who underwent intravesical platelet-rich plasma or botulinum toxin A injection.




Abbreviations: PRP: platelet-rich plasma, BoNT-A: botulinum toxin A, ICSI: interstitial cystitis symptom index, ICPI: interstitial cystitis problem index, VAS: visual analog score, FBC: functional bladder capacity, Qmax: maximum flow rate, PVR: post-void residual, MBC: maximal bladder capacity.

Table 2 shows the changes in IC symptom score, VAS scores for bladder pain, and GRA from baseline to all follow-up points between groups. The improvement in ICSI and ICPI from baseline to each time-point was significant in both groups, but no significant difference was noted between groups. The change in the VAS score after treatment was significant only in the BoNT-A group; however, the change in VAS score from baseline to the follow-up time points was not significant between groups. Interestingly, the GRA was significantly improved only in the PRP group.

**Table 2.** Changes in symptom scores and the global response assessment after intravesical PRP or BoNT-A injection for patients with IC/BPS.


\* *p* < 0.05 compared with baseline data, Abbreviations: GRA: global response assessment, PRP: platelet-rich plasma, BoNT-A: botulinum toxin A, ICSI: interstitial cystitis symptom index, ICPI: interstitial cystitis problem index, VAS: visual analog score.

Table 3 shows the differences in voiding and uroflowmetry parameters between the PRP and BoNT-A groups. Although nocturia and FBC were improved in the PRP group and frequency was improved at the one-month follow-up in the BoNT-A group, there was no significant difference all follow-up time points in the BoNT-A group; however, the change in post-void residual (PVR) was only significantly higher in the BoNT-A group at one month. We found the GRA increased with repeated monthly injections of PRP, whereas the GRA was mildly improved immediately after BoNT-A injection but improved to a level similar to that of PRP at six months. Nevertheless, more patients in the BoNT-A group complained of dysuria after treatment, and a significantly higher rate of urinary tract infection (UTI) (15.4% vs. none) developed after the BoNT-A injection compared with that of patients receiving the PRP injection (Table 4).


**Table 3.** Changes in voiding and uroflow measurements after intravesical PRP or BoNT-A injection for patients with IC/BPS.

\**p* < 0.05 compared with baseline data, Abbreviations: PRP: platelet-rich plasma, BoNT-A: botulinum toxin A, FBC: functional bladder capacity, Qmax: maximum flow rate, PVR: post-void residual.

**Table 4.** Changes in the global response assessment and adverse events after intravesical PRP or BoNT-A injection for patients with IC/BPS.


Abbreviations: GRA: global response assessment, PRP: platelet-rich plasma, BoNT-A: botulinum toxin A, AE: adverse event, UTI: urinary tract infection.

Figure 1 shows the cumulative success rate curve after intravesical PRP or BoNT-A injection. Approximately 50% of patients in each group received an additional bladder therapy for bothersome symptoms after six months. There was no significant difference in the successful curves with time between groups.

**Figure 1.** Survival curves of patients with IC/BPS who received either intravesical PRP or BoNT-A injections. Curves from the initial treatment day to the time in which they received additional treatment.
