Our own experience in surgical treatment of female patients with interstitial cystitis
Article published in Urologia Polska 2007/60/2.

authors

Paweł Wędzikowski ¹, Zofia Salska ³, Ryszard Maranda ², Krzysztof Pliszek ³, Jacek Przybyła ¹, Marek Sosnowski ¹

¹ I Klinika Urologii Katedry Urologii Uniwersytetu Medycznego w Łodzi
² Oddział Urologii i Onkologii Urologicznej Wojewódzkiego Zespołu Zakładów Opieki Zdrowotnej Centrum Leczenia Chorób Płuc i Rehabilitacji w Łodzi
³ Oddział Urologii Szpitala Wojewódzkiego w Bielsku-Białej

keywords

urinary bladder, interstitial cystitis, surgical treatment, augmentation ileocystoplasty

summary

Introduction and the aim of the study. The objective of our study was a retrospective analysis of the results of the management of the patients with IC who within the last 20 years were admitted to our department and have undergone supratrigonal cystectomy and augmentation ileocystoplasty.

Material and methods. 30 cases of IC female patients were analyzed. The initial diagnosis was based on a typical clinical presentation of the disease and a characteristic cystoscopy image.

As the initial conservative treatment did not lead to any improvement, a surgical approach has been proposed and accepted without reservations by all the patients. The outcome of surgery was assessed by an analysis of the short- and long-term follow-up results. The patients were asked to fill a questionnaire focused on a subjective assessment of the symptoms, i. e. severity and type of pain, frequency and urgency in pre and postoperative period. In addition, they were also asked to complete a daily voiding diary. The pre- and post-operative data were compared and analyzed. 22 patients replied to the questionnaire and were followed-up.

Results. In all the patients there was relief of pain of the bladder /complete in 15 (68.2%), significant in 3 (13.6%), moderate in 3 (13.6%) and little in 1 (4.5%) /. The relief in frequency was complete in 13 (59%) patients, significant in 5 (22.7%) moderate in 3 (13.6%), and little in 1 (4.5%). The capacity of the bladder increased on average by 65 cm3 (39.4%), and frequency of urination decreased from 21 to 9 (57.1%). Five patients (22.7%) from the complete relief of symptoms group reported a periodical painless recurrence of frequency. 19 patients (86.4%) were satisfied with the surgical treatment and none of the patients complained of the lack of improvement after the operation. There was no mortality among the patients and only marginal peri-operative complications were noted. Late postoperative complications included urinary retention that in 3 patients (10%) required self catheterization. In 1 patient (3.3%), several episodes of acute pyelonephritis resulted in the cirrhosis of the kidney and arterial hypertension, that finally led to an extraction of the damaged left kidney. In 2 cases (6.6 %), urinary diversion-ileal conduit was necessary; in the first one, due to the postoperative complications, in the second one, because of the recurrence of the disease.

Conclusion. Supratrigonal cystectomy and augmentation ileocystoplasty present a good surgical modality in the management of patients with IC not responding to the initial conservative therapy.

references

correspondence