Female Urology, Urodynamics, Incontinence, and Pelvic Floor Reconstructive SurgeryIs Urethrectomy Necessary During Cystectomy in Patients With Interstitial Cystitis or Bladder Pain Syndrome?
Section snippets
Materials and Methods
The medical records of the urogynecology and neurourology department outpatients experiencing frequent and painful urination for a long duration were reviewed. A voiding diary lasting at least 3 consecutive days, a detailed symptom history, physical examination, urinalysis, immunological blood test, and psychosomatic evaluation were performed initially to rule out other conditions including overactive bladder, urinary tract infection, colpitis, immune system disorders, and psychosomatic
Results
During the period from 2007 to 2014, 332 consecutive male and female outpatients were diagnosed and treated for IC/BPS. In total, 18 women (5.42%) with a median age of 63.0 years (interquartile range [IQR] from 55.5 to 67.8) were eligible and elected for surgical intervention due to conservative treatment failure. The baseline population preoperative characteristics are presented in Table 1. All O'Leary-Sant questionnaire indices scored 20, reflecting the severity of the condition. Among the
Comment
We summarized our clinical experience and postoperative outcomes in 18 patients who underwent surgery for intractable IC/BPS. The diagnosis and conservative treatment was based on the American Urological Association guidelines.2 Surgical candidate identification and operative planning were evidence-based and tailored to each case. Although the technique remains controversial,17 urinary diversion without cystectomy has reportedly promising outcomes in select patients. In a long-term study,
Conclusion
Based on the present understanding of interstitial cystitis or bladder pain syndrome and available medical management options, major surgery cannot be completely avoided; however, careful and thorough preoperative evaluation of the individual benefits and risks is required. Favorable subjective and objective outcomes can be obtained in appropriately selected patients. Transvaginal urethrectomy was not recommended in the initial major surgery, yet it is difficult to draw generalizations with
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Financial disclaimer: The authors declare that they have no relevant financial interests.
De-Yi Luo and Tong-Xin Yang contributed equally to this work and should be considered as co-first author.