Intravesical Injection of Dental Pulp-Derived Exosomes

“My bladder is constantly in pain.”

“No matter how often I urinate, I can’t find relief.”

These are common voices of those suffering from interstitial cystitis/bladder pain syndrome (IC/BPS). Among them, Hunner-type IC, characterized by the presence of Hunner’s lesions (ulcers on the bladder lining), is known to be particularly severe and resistant to standard treatment.

Even today, this subtype remains difficult to manage, with many patients struggling for years without sufficient relief.

💡 A New Attempt: Intravesical Administration of Exosomes

Recently, we performed a new approach using dental pulp-derived exosomes in a patient with long-standing Hunner-type IC/BPS.

Specifically, we administered a 10-fold concentrated solution of exosomes derived from human exfoliated deciduous teeth (SHEDs) directly into the bladder submucosa via cystoscopic injection.

✅ Case Background

Female patient with a long history of chronic bladder pain Often awakened at night due to pain Has undergone various standard therapies: oral medications, bladder hydrodistension, electrocautery, DMSO, heparin, and hyaluronic acid instillations Could not continue DMSO therapy due to worsening pain afterward Previously experienced partial pain relief after intravenous infusion of exosomes Expressed strong desire to try intravesical treatment: “If there’s even a small chance of relief, I want to try.”

🔬 Treatment Details and Early Results

Substance: SHED-derived exosomes (10× concentrated) Method: Cystoscopic submucosal injection into multiple bladder sites 10 days post-treatment: The patient reported “pain is about 10% of what it used to be,” indicating significant improvement We plan to repeat the treatment every 4 weeks for a total of 3 sessions and evaluate the outcome over time

📌 Positioning of Exosome Therapy in Our Practice

While exosome therapy is gaining attention as a promising tool in regenerative medicine, evidence for its efficacy in IC/BPS is still very limited, and it remains an exploratory treatment.

Therefore, our clinic adopts the following stepwise approach:

Start with all standard treatments covered by insurance, such as oral medications and intravesical therapies Consider guideline-based non-insured therapies when needed Only after those fail, we may cautiously consider regenerative approaches like PRP or exosomes

🌱 A Small Step Toward a Better Future

It is still too early to determine whether this patient will maintain improvement or achieve long-term remission. However, for her, the reduction in pain was immediate and meaningful, greatly improving her quality of life.

Exosome therapy may not yet be widely accepted in clinical guidelines, but for certain patients, it could become a valuable part of future personalized care, especially when conventional treatments fall short.