Objective:The role of major surgery in patients with bladder pain syndrome/interstitial cystitis (BPS/IC) is not fully established.
This report presents a single-institution experience with major surgery in patients with disabling BPS/IC where conservative treatment had failed.
Material and Methods: Forty-one patients (34 women, seven men) with BPS/IC refractory to conservative treatment underwent major surgery from 1983 to 2004. Surgical approach was determined on a case-by-case basis. Postoperative pain and satisfaction were assessed by a questionnaire.
Results: Cystectomy was the primary procedure in five patients. The remaining 36 patients were primarily operated on with subtotal cystectomy and bladder augmentation (n = 16) or supravesical urinary diversion with intact bladder (n = 20). Thirteen of these patients were later operated on with cystectomy due to persisting pain 12 (6-146) months after the primary procedure. The questionnaire was answered by 38 of 41 patients after a median follow-up of 66 (6-238) months. In total, 28 patients (74%) were free of pain, and 26 patients (68%) were satisfied with the end result. There was no difference in reported pain between cystectomized and non-cystectomized patients. When comparing patients who reported pain at follow-up with those who did not report pain, preoperative length of symptoms was significantly increased, with 12.1 compared to 5.4 years (p = 0.02).
Conclusions: Major surgery is associated with good symptom relief in strictly selected patients with disabling BPS/IC, where conservative treatment has failed. Extended preoperative duration of symptoms may be a predictor for persisting pain after major surgery for BPS/IC.
Written by:
Andersen AV, Granlund P, Schultz A, Talseth T, Hedlund H, Frich L. Are you the author?
Department of Urology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Reference: Scand J Urol Nephrol. 2012 Mar 27. Epub ahead of print.
doi: 10.3109/00365599.2012.669789
PubMed Abstract
PMID: 22452583
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