Is Urethrectomy Necessary during Cystectomy in Patients with Interstitial Cystitis/Bladder Pain Syndrome?

To assess the outcome of cystectomy and cystourethrectomy in patients with intractable IC/BPS, and to identify whether the urethrectomy is necessary.

During 2007 to 2014, 18 women were eligible and elected surgical treatment after conservative treatment failed. Seven cystectomies with ileal conduit urinary diversions, eight cystourethrectomies with ileal conduit urinary diversions, and three supratrigonal cystectomy with orthotopic ileocystoplasty were performed. Patient histories, perioperative medical records, and follow-up outcomes were evaluated and summarized.

Patients reported subjectively improved social function and mental condition secondary to decreased urination frequency postoperatively. Pain also significantly decreased compared with baseline. To date, additional surgery to alleviate persistent symptoms or postoperative complications has not been necessary. Furthermore, there was no association between reported urethral pain and the initial transvaginal urethrectomy incidence (p = 0.326). More operation time and longer postoperative hospitalization duration was recorded without better surgical outcomes in the urethrectomy group (p values < 0.05).

Cystectomy and cystourethrectomy is effective and adequate treatment for IC/BPS, and our experience indicates that urethrectomy are not routinely needed. However, further long-term, prospective studies involving a larger study group are needed.

Urology. 2016 Jul 13 [Epub ahead of print]

Tong-Xin Yang, De-Yi Luo, Hong Li, Kun-Jie Wang, Hong Shen

Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China., Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China. Electronic address: ., Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China., Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China., Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China.