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


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


urinary bladder, interstitial cystitis, surgical treatment, augmentation ileocystoplasty


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.


  1. Oravisto KJ, Alfthan OS: Epidemiology of interstitial cystitis. Ann Chir Gynaecol Finn 1975, 64, 75.
  2. Leppilahti M, Sairanen J, Tammela TL et al: Prevalence of clinicaly confirmed interstitial cystitis in women: a population based study in Finnland. J Urol 2005, 174, 571.
  3. Curhan CG, Speizer EF: Epidemiology of interstitial cystitis: A population based study. J Urol 1999, 161, 549.
  4. Parsons CL, Dell J, Stanford EJ et al: Increased prevalence of interstitial cystistis: previously unrecognized urologic and gynecologic cases identified using a new symptom questionnaire and intravesical potassium sensitivity. Urology, 2002, 60, 573.
  5. Parsons CL: Editorial: changing concepts in interstitial cystitis. J Urol 1997, 158, 794.
  6. Keay S, Zhang C. O, Chai T. et al: Antiproliferative factor, heparin-binding epidermal growth factor-like growth factor and epidermal growth factor in men with interstitial cystitis versus chronic pelvic pain syndrome. Urology, 2004, 63, 22.
  7. Parsons CL: Strategie rozpoznawania i leczenia śródmiąższowego zapalenia pęcherza moczowego na podstawie aktualnych i wiarygodnych danych. Contemporary Urology. Wydanie Polskie, Warszawa, 2003, 1, 10, 4.
  8. Sairanen J, Forsell T, Ruutu M: Long- term outcome of patients with interstitial cystitis treated with low dose cyclosporine. J. Urol 2004, 171, 2138.
  9. Bouchelouche K, Nordling J, Hald T, Bouchelouche P: The cysteinyl leukotriene D4 receptor antagonist montelukast for the treatment of interstitial cystitis. J Urol 2001, 166, 1734.
  10. Smith CP, Radziszewski P, Borkowski A et al: Botulinum toxin a has a antinociceptive effects in treating interstitial cystitis. Urology, 2004, 64, 871.
  11. Rofeim O, Horn D, Freid RM, Moldwin RM: Use of the neodymium: YAG laser for interstitial cystitis: a prospective study. J Urol 2001, 166, 134.
  12. Comiter CV: Sacral neuromodulation for the symptomatic treatment of refractory interstitial cystitis: a prospective study. J Urol 2003, 169, 1369.
  13. Hanno P: Interstitial cystitis and related diseases. In Campbell´s Urology 8th ed. Saunders, Philadelphia, 2002, Vol 1, 631-670.
  14. Hohenfellner M, Linn J, Hampel C, Thuroff J: Surgical treatment of interstitial cystitis in women. In: Sant G. R. Interstitial cystitis. Editor - Lippincott-Raven, Philadelphia. 1997, 222.
  15. Linn J F, Hohenfellner M: Treatment of interstitial cystitis: comparison of subtrigonal and supratrigonal cystectomy combined with orthotopic bladder substitution. J Urol 1998, 159, 774.
  16. Bruce P, Bucham GJ, Garden AB, Salvaris M: The surgical treatment of chronic interstitial cystitis. Med J Aust 1, 1977, 581.
  17. Kontturi MJ, Hellstrom PA, Tammela TL, Lukkarinen OA: Colocystoplasty for the treatment of severe interstitial cystitis. Urol Int 1991, 46, 50.
  18. Nielsen KK, Kroman-Andersen B, Steven K, Hald T: Failure of combined supratrigonal cystectomy and Mainz ileocecocystoplasty in intractable interstitial cystitis: is histology and mast cell count a reliable predictor for the outcome of surgery? J Urol 1990, 144, 255.
  19. Ophoven A, Rossbach G, Oberpenning F, Hertle L: Hyperbaric oxygen for the treatment of interstitial cystitis: long-term results of a prospective pilot study. Eur Urol 2004, 46, 108.
  20. Hohenfellner M, Linn JF, Thuroff JW et al: Interstitial cystitis: Orthotopic bladder substitution with the Mainz-Pouch I. J Urol 1996, 155, 589.
  21. Blaivas JG, Weiss JP, Desai P: Long-term followup of augmentation enterocystoplasty and continent diversion in patients with benign disease. J Urol 2005, 173, 1631.
  22. Huges OD, Kynaston HG, Jenkins BJ et al: Substitution cystoplasty for intractable interstitial cystitis. Br J Urol 1996, 77, 607.
  23. Christmas TJ, Holmes SA, Hendry WF: Bladder replacement by ileocystoplasty: the final treatment for interstitial cystitis. Br J Urol 1996, 78, 69.
  24. Wędzikowski P, Salska Z, Maranda R i in: Własne doświadczenia w chirurgicznym leczeniu śródmiąższowego zapalenia pęcherza moczowego. Urol Pol 2005, 58, Suppl 1, 112.
  25. Karsenty G, Taweel W, Hajebrahimi S, Coros J: Efficacy of interstitial cystitis treatments: a review. Eur Urol 2006, 4, 47.


Paweł Wędzikowski
I Klinika Urologii UM
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