Bladder necrosis following hydrodistention in patients with interstitial cystitis.
OBJECTIVE
Bladder hydrodistention is used to diagnose and treat patients with interstitial cystitis. This procedure has been shown to have minimal morbidity and provide symptomatic relief in a subset of patients with interstitial cystitis. We report our experience with almost total bladder necrosis after hydrodistention at 2 institutions. To our knowledge this rare complication has not been previously reported in the literature. We also reviewed the literature regarding complications of hydrodistention and discuss their possible etiology.


METHODS
We report 3 cases of bladder necrosis after therapeutic hydrodistention for interstitial cystitis at 2 institutions. All records were reviewed, and the clinical presentation, findings and treatments are discussed. A literature review was performed to evaluate the effectiveness and complications of hydrodistention for interstitial cystitis.


RESULTS
There were 2 female and 1 male patient between ages 29 and 46. All patients had a previous diagnosis of interstitial cystitis and had been previously treated with hydrodistention. All patients presented with severe abdominal pain and had necrosis of the entire bladder wall with sparing of the trigone. Two patients were treated with supratrigonal cystectomy. A review of the literature revealed little data on the effectiveness of hydrodistention for interstitial cystitis.


CONCLUSIONS
Vesical necrosis is a rare but devastating complication of hydrodistention. It can occur in young patients in the absence of a contracted bladder and it usually presents as severe postoperative abdominal pain. At exploration bladder necrosis with sparing of the trigone was observed. All patients required enterocystoplasty.
Zabihi
Nasim
N
Geffen School of Medicine at University of California-Los Angeles, Los Angeles, USA.
Allee
Tina
T
Maher
Mary Grey
MG
Mourtzinos
Arthur
A
Raz
Shlomo
S
Payne
Christopher K
CK
Rodríguez
Larissa V
LV
D000328:Adult; D018856:Cystitis, Interstitial / Q000628:therapy*; D004106:Dilatation / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000209:etiology; D012189:Retrospective Studies; D001743:Urinary Bladder / Q000473:pathology*; D014867:Water
D014867:Water