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Caecocystoplasty for intractable interstitial cystitis: long-term results.
Aniruddha Chakravarti1, Suresh Ganta, Bhaskar Somani
1Sandwell Hospital, West Bromwich, 181, Quinton Road, Harborne, Birmingham B17 0RN, UK. anichak@hotmail.com
European Urology
|June 9, 2004
Summary
Orthotopic substitution caecocystoplasty offers sustained symptom relief for interstitial cystitis. However, long-term monitoring is crucial due to potential malignancy risks in the augmentate.
Area of Science:
- Urology
- Surgical Oncology
Background:
- Interstitial cystitis is a chronic bladder condition often refractory to conservative treatments.
- Orthotopic substitution caecocystoplasty is a surgical option for severe cases.
Purpose of the Study:
- To assess the long-term efficacy and safety of trigone-preserving orthotopic substitution caecocystoplasty for intractable interstitial cystitis.
Main Methods:
- Retrospective review of eleven patients with intractable interstitial cystitis.
- Trigone-preserving orthotopic substitution caecocystoplasty performed.
- Mean follow-up of nine years (range 4-14 years) including symptom evaluation, biochemistry, ultrasound, and cystoscopy.
Main Results:
- Universal symptomatic relief and normalization of bladder capacity observed.
- Minimal postoperative morbidity with no mortality.
- Two patients required cystectomy; one patient developed adenocarcinoma in the caecal segment.
Conclusions:
- Trigone-preserving orthotopic substitution caecocystoplasty provides sustained symptom relief for interstitial cystitis.
- The procedure may be contraindicated in patients with urethro-trigonal disease or hypersensitivity.
- Long-term surveillance is essential to detect malignancy in the augmented bladder segment.