Cystectomy for patients with Hunner-type interstitial cystitis at a tertiary referral center in Japan.

To evaluate the outcomes of partial and total cystectomy in patients with refractory Hunner-type interstitial cystitis (HIC).

Patients with end-stage HIC who underwent supratrigonal partial cystectomy with augmentation ileocystoplasty (PC-CP) or total cystectomy with ileal conduit (TC-IC) were identified retrospectively. Changes in the 11-point numerical rating scale of bladder pain and in 7-grade quality of life (QOL) scores were evaluated. Changes in the O'Leary and Sant's Symptom Index (OSSI) and O'Leary and Sant's Problem Index (OSPI) were analyzed in patients with PC-CP. Peri- and postoperative complications and patient satisfaction with overall outcomes were examined.

Four patients (one female) underwent PC-CP and 13 (nine females) underwent TC-IC. Bladder pain persisted in three PC-CP patients, but resolved completely in all TC-IC patients. Pain scale and QOL scores improved significantly in patients with TC-IC (P < .01), but not in those with PC-CP. OSSI/OSPI scores did not improve significantly in patients with PC-CP. Three PC-CP patients required clean intermittent catheterization due to voiding dysfunction or persistent pain. Two TC-IC patients developed stricture of the ureteroileal anastomosis, resulting in permanent placement of a ureteral stent in one case and nephrostomy in the other. Satisfaction rate was higher in the TC-IC than in the PC-CP group (76.9% vs 25.0%, P < .05).

TC-IC provided reliable pain relief and improved QOL in patients with end-stage HIC, but the small case number and limited methodology restrict interpretation of the results. Further studies are needed to identify appropriate candidates and optimal surgical procedures.

Lower urinary tract symptoms. 2021 Oct 26 [Epub ahead of print]

Yoshiyuki Akiyama, Aya Niimi, Yasuhiko Igawa, Akira Nomiya, Yuta Yamada, Yusuke Sato, Taketo Kawai, Daisuke Yamada, Haruki Kume, Yukio Homma

Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Department of Urology, New Tokyo Hospital, Matsudo, Japan., Department of Urology, Nagano Prefectural Shinshu Medical Center, Suzaka, Japan., Department of Urology, National Center for Global Health and Medicine, Tokyo, Japan., Japanese Red Cross Medical Center, Tokyo, Japan.

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