Ileal conduit without cystectomy may be an appropriate option in the treatment of intractable bladder pain syndrome/interstitial cystitis

Abstract

Objective. The aim of this study was to report the outcomes of urinary diversion for bladder pain syndrome/interstitial cystitis (BPS/IC) at a large university hospital over a period of more than 10 years. Material and methods. Chart reviews were performed for BPS/IC patients who had undergone ileal conduit with or without cystectomy. Questionnaires on quality of life, BPS/IC symptoms and pain were mailed to patients. Outcomes in the cystectomy and the non-cystectomy groups were compared with Fisher's exact test. Results. Ileal conduit without cystectomy was performed in 20 patients. Two underwent a subsequent cystectomy owing to persistent symptoms. Three patients underwent ileal conduit with concomitant primary cystectomy. Nineteen patients were alive at the time of the study and 15 returned the questionnaires. Twelve responders had been treated with ileal conduit and three had undergone primary cystectomy. The quality of life in both the cystectomy and the non-cystectomy groups was comparable with that in the general population. Seven patients in the non-cystectomy group were free of specific BPS/IC symptoms. The remaining five patients had minimal symptoms. Two cystectomy patients were free of symptoms, while one still suffered from severe symptoms. Eleven patients reported having no pain while four patients had visual analogue scale (VAS) scores between 2 and 9.5. Three patients experiencing pain belonged to the non-cystectomy group. There was no difference between the cystectomy group and the non-cystectomy group with regard to the proportion of patients who were symptom free. Conclusion. Ileal conduit without cystectomy may be an appropriate option when performing urinary diversion in BPS/IC patients.

Key Words::

• Bladder pain syndrome
• cystectomy
• ileal conduit
• interstitial cystitis
• urinary diversion

Declaration of interest: No research support was received for the current study. The authors have no conflicts of interest.