title: Efficacy and safety of augmentation ileocystoplasty combined with supratrigonal cystectomy for the treatment of refractory bladder pain syndrome/interstitial cystitis with Hunner's lesion.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of augmentation ileocystoplasty with supratrigonal cystectomy for the treatment of refractory bladder pain syndrome/interstitial cystitis patients with Hunner's lesion.
  
  
  METHODS
  Of 45 patients who underwent augmentation ileocystoplasty with supratrigonal cystectomy between July 2006 and June 2012, 40 patients (33 women, 7 men) were included in the analysis. Primary outcome was the change in the O'Leary-Sant interstitial cystitis symptoms/problem index from baseline to 1, 3 and 6 months. Changes in pain, urgency, frequency, functional bladder capacity and maximal cystometric capacity were also assessed. Intraoperative and postoperative complications were evaluated.
  
  
  RESULTS
  Median preoperative symptom duration was 5.0 years (range 3.0-6.0 years). Pain decreased significantly after surgery (8.3 vs. 1.3, P < 0.001). Functional bladder capacity and maximal cystometric capacity increased, whereas frequency, urgency and nocturia decreased significantly after surgery (all P < 0.001). At 6 months, significant improvements in the interstitial cystitis symptom index (17.8 vs. 9.9, P < 0.001) and interstitial cystitis problem index (14.6 vs. 6.5, P < 0.001) compared with baseline were noted. Seven patients developed vesicoureteral reflux and seven patients had acute pyelonephritis that resolved with antibiotic treatment. Five patients required clean intermittent self-catheterization. None of the preoperative factors were significant predictors of treatment failure.
  
  
  CONCLUSIONS
  Augmentation ileocystoplasty with supratrigonal cystecomy decreased pain and frequency, and increased bladder capacity significantly. There were no severe complications related to surgery during follow up. Augmentation ileocystoplasty with supratrigonal cystectomy is therefore an appropriate final treatment strategy for refractory bladder pain syndrome/interstitial cystitis patients with Hunner's lesion.
authors.affiliation: Department of Urology, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Hyung Joon
authors.initials: HJ
authors.lastname: Kim
authors.forename: Jae Seong
authors.initials: JS
authors.lastname: Lee
authors.forename: Won Jin
authors.initials: WJ
authors.lastname: Cho
authors.forename: Hyo Serk
authors.initials: HS
authors.lastname: Lee
authors.forename: Ha Na
authors.initials: HN
authors.lastname: Lee
authors.forename: Hyun Wook
authors.initials: HW
authors.lastname: You
authors.forename: Wonho
authors.initials: W
authors.lastname: Jung
authors.forename: Kyu-Sung
authors.initials: KS
authors.lastname: Lee
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015653:Cystectomy / Q000009:adverse effects / Q000379:methods; D018856:Cystitis, Interstitial / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery*; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D010148:Intractable Pain / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy; D011704:Pyelonephritis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D019651:Plastic Surgery Procedures / Q000379:methods; D056910:Republic of Korea; D012189:Retrospective Studies; D016896:Treatment Outcome; D014456:Ulcer / Q000209:etiology / Q000601:surgery; D001743:Urinary Bladder / Q000473:pathology / Q000601:surgery; D014546:Urinary Catheterization / Q000379:methods; D014547:Urinary Diversion / Q000009:adverse effects / Q000379:methods; D014718:Vesico-Ureteral Reflux / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents
keywords: interstitial cystitis; painful bladder syndrome; reconstructive surgical procedure; refractory pain; urinary bladder