Autologous platelet-rich plasma (PRP) has gained increasing attention in urology. However, data on its efficacy following transurethral coagulation of Hunner’s ulcers in patients with bladder pain syndrome (BPS) remain limited. This study aimed to evaluate the effectiveness of PRP in interstitial cystitis (IC) combined with transurethral coagulation of Hunner’s ulcers.

The study included 53 patients (aged 28–73 years, mean 53.3±15.2) treated at Sverdlovsk Regional Clinical Hospital No. 1. Group A comprised 28 BPS patients with Hunner’s ulcers who underwent ulcer coagulation alone. Group B included 25 BPS/IC patients with Hunner’s ulcers who received intravesical PRP injections post-coagulation. Group A underwent standard transurethral bladder coagulation. Group B received three monthly intravesical injections of PRP into the bladder wall following surgery. Treatment efficacy was assessed using voiding diaries and validated questionnaires.

All patients tolerated the procedures well, with no serious complications or adverse events reported. Both groups demonstrated increased maximum bladder capacity (voiding diary: 84±23 mL to 135±28 mL), reduced urinary frequency (23.0±7.5 to 15.2±5.6 voids/day), and decreased pain scores (visual analog scale [VAS]: 6.5±2.1 to 2.4±1.2) after transurethral bladder coagulation. At 6-month follow-up, Group B maintained stable VAS scores and voiding parameters (comparable to post-third PRP injection). In contrast, Group A showed increased frequency (19.4±3.1 voids/day), reduced bladder capacity (95±12 mL), and worsened pain (VAS increase of 1–2 points).

The superior long-term outcomes observed in patients receiving intravesical PRP injections suggest that autologous growth factors may modulate the healing process following Hunner's ulcer coagulation. The sustained clinical effect (maintained at 6 months) supports the hypothesis that PRP promotes tissue regeneration rather than providing merely temporary symptomatic relief. The worsening parameters in the control group (Group A) highlight the limitations of standard coagulation alone in managing this chronic condition. These findings position PRP as a potential disease-modifying therapy for BPS/IC with Hunner's lesions, possibly through anti-inflammatory and neoangiogenic mechanisms.

Intravesical autologous platelet-rich plasma (PRP) injections are safe and prolong the therapeutic effect of transurethral bladder coagulation in bladder pain syndrome.