Outcomes of surgery for treatment refractory bladder pain syndrome / interstitial cystitis
BAUS ePoster online library. Downey A. Jun 27, 2018; 211401; P10-13
Ms. Alison Downey
Ms. Alison Downey
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Abstract
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Background: Bladder pain syndrome/interstitial cystitis (BPS/IC) is a chronic debilitating condition with the majority of treatment options medical. Surgery is reserved for treatment refractory patients however the optimum procedure is not defined. We describe the outcomes of reconstructive surgery for BPS/IC in our centre.

Patients and Methods: A retrospective review of prospective data on patients undergoing surgery for BPS/IC in a single tertiary referral centre from 2007-2017 was performed. Data collected included preoperative investigations/treatments, surgical approach, complications and outcomes.

Results: 34 patients were identified (15 male, 19 female). Median age was 50. Mean pre-operative symptom duration was 6.4 years and all were considered treatment refractory. Median nocturia episodes was 6 and median daytime frequency was 1 hourly. Mean pre-op maximum anaesthetic bladder capacity was 483.3ml. 23 patients underwent cystectomy & ileal conduit formation (67.6%), 4 cystectomy & neobladder formation (11.8%) and 7 subtotal cystectomy & ileocystoplasty (20.6%). Clavien-Dindo grade III-V complications occurred in 4 patients (10.8%) with 1 90-day mortality. Median follow-up was 32 months. 22 patients (64.7%) were considered cured i.e. no pain. 32.3% had continued pain following surgery: 28.6% (2) had undergone subtotal cystectomy & ileocystoplasty, 30.4% (7) total cystectomy & ileal conduit and 50% (2) total cystectomy & neobladder formation.

Conclusion: Reconstructive surgery can result in resolution of BPS/IC symptoms but should be considered a last resort due to the potential morbidity and risk of persistent symptoms in just over a third of patients. There is a need to identify preoperative factors that may predict a poor outcome.
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