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Related Experiment Videos

Substitution cystoplasty for intractable interstitial cystitis

O D Hughes1, H G Kynaston, B J Jenkins

  • 1Department of Urology, Cardiff Royal Infirmary, UK.

British Journal of Urology
|August 1, 1995
PubMed
Summary

Substitution cystoplasty can effectively treat interstitial cystitis (IC) when bladder capacity is less than 250 mL. Pre-operative bladder capacity is a key predictor of successful outcomes for this IC treatment.

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Area of Science:

  • Urology
  • Surgical Oncology

Background:

  • Interstitial cystitis (IC) is a chronic condition causing bladder pain and urinary urgency.
  • Substitution cystoplasty is a surgical option for intractable IC cases resistant to conservative therapies.

Purpose of the Study:

  • To evaluate the effectiveness of substitution cystoplasty in treating patients with severe interstitial cystitis (IC).
  • To identify predictors of successful surgical outcomes for IC patients.

Main Methods:

  • A retrospective review of 32 patients (29 women, 3 men) with intractable IC who underwent substitution cystoplasty between 1983 and 1992.
  • Analysis of pre-operative anesthetic bladder capacity in relation to treatment outcomes.

Main Results:

  • Patients with pre-operative bladder capacity < 250 mL had a high success rate (15 cured, 5 improved).

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  • Outcomes were less favorable for patients with larger bladder capacities.
  • Men generally experienced good results; supratrigonal cystectomy facilitated spontaneous voiding but increased pyelonephritis risk.
  • Subtotal cystectomy reduced reflux risk but potentially increased the need for intermittent self-catheterization (ISC).

    • Conclusions:

    • Pre-operative bladder capacity under anesthesia is the most reliable predictor for substitution cystoplasty success in women with IC.
    • Bladder capacity > 250 mL is a contraindication for this procedure.
    • Supratrigonal cystectomy is suitable for older patients, while subtotal cystectomy may be better for younger patients despite increased ISC needs.