Elaine J Redmond1, Hugh D Flood2. 1. Department of Urology, University Hospital of Limerick, Limerick, Ireland. elaineredmond@rcsi.ie. 2. Department of Urology, University Hospital of Limerick, Limerick, Ireland.
Abstract
INTRODUCTION: Interstitial cystitis is a debilitating condition that has a profound effect on quality of life. Although many approaches to treatment have been explored, no consistently effective treatment has been identified. Reconstructive surgery is offered to patients with refractory IC/BPS; however, expert opinion is divided as to whether simultaneous cystectomy is necessary to achieve symptomatic cure. The aim of this study was to report our experience in the surgical management of IC/BPS in a university teaching hospital. METHODS: The hospital inpatient enquiry (HIPE) system was used to identify patients with IC/BPS who underwent surgery between 1997 and 2013. Medical records were examined and patients were invited to complete three symptom-based questionnaires. RESULTS: Twelve patients were identified (8 female, 4 male). Reconstructive procedures included urinary diversion without cystectomy (9) and augmentation ileocystoplasty (4). One patient failed to have a sustained improvement in symptoms following ileocystoplasty and later underwent successful urinary diversion. All other patients noted a "marked improvement" in overall symptoms on global response assessment (GRA) and the resolution of bladder pain on a visual analogue sale (VAS). There were no persistent symptoms or complications related to the retained bladder following diversion. CONCLUSION: Our study adds to the existing evidence that cystectomy is not necessary to provide symptomatic cure in patients with end-stage IC/BPS. Urinary diversion without cystectomy is a highly effective operation and a successful outcome was achieved in all patients. Ileocystoplasty may be offered in carefully selected cases.
INTRODUCTION:Interstitial cystitis is a debilitating condition that has a profound effect on quality of life. Although many approaches to treatment have been explored, no consistently effective treatment has been identified. Reconstructive surgery is offered to patients with refractory IC/BPS; however, expert opinion is divided as to whether simultaneous cystectomy is necessary to achieve symptomatic cure. The aim of this study was to report our experience in the surgical management of IC/BPS in a university teaching hospital. METHODS: The hospital inpatient enquiry (HIPE) system was used to identify patients with IC/BPS who underwent surgery between 1997 and 2013. Medical records were examined and patients were invited to complete three symptom-based questionnaires. RESULTS: Twelve patients were identified (8 female, 4 male). Reconstructive procedures included urinary diversion without cystectomy (9) and augmentation ileocystoplasty (4). One patient failed to have a sustained improvement in symptoms following ileocystoplasty and later underwent successful urinary diversion. All other patients noted a "marked improvement" in overall symptoms on global response assessment (GRA) and the resolution of bladder pain on a visual analogue sale (VAS). There were no persistent symptoms or complications related to the retained bladder following diversion. CONCLUSION: Our study adds to the existing evidence that cystectomy is not necessary to provide symptomatic cure in patients with end-stage IC/BPS. Urinary diversion without cystectomy is a highly effective operation and a successful outcome was achieved in all patients. Ileocystoplasty may be offered in carefully selected cases.
Authors: Naoki Yoshimura; Nelson E Bennett; Yukio Hayashi; Teruyuki Ogawa; Osamu Nishizawa; Michael B Chancellor; William C de Groat; Satoshi Seki Journal: J Neurosci Date: 2006-10-18 Impact factor: 6.167
Authors: Joop P van de Merwe; Jørgen Nordling; Pierre Bouchelouche; Kirsten Bouchelouche; Mauro Cervigni; L Kurosch Daha; Suzy Elneil; Magnus Fall; Gero Hohlbrugger; Paul Irwin; Svend Mortensen; Arndt van Ophoven; John L Osborne; Ralph Peeker; Benedikte Richter; Claus Riedl; Jukka Sairanen; Martina Tinzl; Jean-Jacques Wyndaele Journal: Eur Urol Date: 2007-09-20 Impact factor: 20.096