Female UrologyCystectomy for Ulcerative Interstitial Cystitis: Sequelae and Patients' Perceptions of Improvement
Section snippets
Materials and Methods
After receiving institutional review board approval, we identified adult men and women (aged 18-90 years) from clinic and hospital billing records at our institution with history of IC/BPS, Hunner's ulcers, and bladder removal. Patients who had IC/BPS and cystectomy for cancer were excluded. All patients had failed to achieve long-term symptom control with ulcer cautery or conservative treatments. One patient had a neobladder created in standard fashion with terminal ileum after urethra-sparing
Results
Ten women with a history of IC/BPS (mean age 64 ± 12.5 years) had cystectomy between 2004 and 2011. Two urologists performed all surgeries. One surgeon created a Hautmann neobladder with terminal ileum after urethral sparing cystectomy in 1 patient and in another, performed a simple cystectomy and ileal conduit urinary diversion. In the remaining 8 patients, the second surgeon performed a simple cystectomy robotically followed by open ileal conduit urinary diversion through an approximately 5-7
Comment
Cystectomy relieved pain and other symptoms in almost all the patients in this study; however, IC/BPS symptoms can persist even after partial or complete bladder removal. In a small series of patients after supratrigonal cystectomy with ileocecocystoplasty, treatment failure required secondary cystectomy and conduit formation in 6 of 8 patients.1 In another study of 41 patients (2 with Hunner's ulcers), 5 had cystectomy and 36 had bladder-conserving procedures. However, 13 of the 36 underwent
Conclusion
In carefully selected patients, cystectomy may be the only reasonable alternative for refractory symptoms especially in those with ulcerative IC/BPS. Overall, patients in this study achieved symptom relief and were quite satisfied with their decision to have the procedure. Before considering cystectomy, patients should be carefully evaluated for potential surgical risks and criteria to ensure they meet current treatment guidelines. Patients should fully understand the risk-benefit ratio
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Cited by (19)
A Systematic Review of Surgical interventions for the Treatment of Bladder Pain Syndrome/Interstitial Cystitis
2021, European Urology FocusElectrosurgical management of Hunner ulcers in a referral center's interstitial cystitis population
2015, UrologyCitation Excerpt :Additionally, ulcerative patients have excellent responses to local treatments11 suggesting that the subtype is more a condition of the bladder. We previously demonstrated the efficacy of cystectomy leading to high levels of patient satisfaction in a small population of ulcerative IC patients' refractory to conservative treatment.6 However, cystectomy is not an acceptable first-line treatment for ulcerative IC.
Optimal endoscopic treatment and partial cystectomy with or without bladder augmentation for Hunner-type interstitial cystitis
2023, LUTS: Lower Urinary Tract SymptomsBladder pain syndrome and sexual function: a systematic review and meta-analysis
2023, International Urogynecology Journal
Funding Support: This work was supported by the Ministrelli Program for Urology Research and Education (MPURE).