Is Urethrectomy Necessary During Cystectomy in Patients With Interstitial Cystitis or Bladder Pain Syndrome?

To assess the outcome of cystectomy and cystourethrectomy in patients with intractable interstitial cystitis or bladder pain syndrome, and to identify whether urethrectomy is necessary.

During 2007-2014, 18 women were eligible and elected for surgical treatment after conservative treatment failed. Seven cystectomies with ileal conduit urinary diversions, 8 cystourethrectomies with ileal conduit urinary diversions, and 3 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 = .326). More operation time and longer postoperative hospitalization duration were recorded without better surgical outcomes in the urethrectomy group (P values <.05).

Cystectomy and cystourethrectomy is effective and adequate treatment for interstitial cystitis or bladder pain syndrome, and our experience indicates that urethrectomy is not routinely needed. However, further long-term, prospective studies involving a larger study group are needed.