Cystectomy for patients with Hunner-type interstitial cystitis at a tertiary referral center in Japan.

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms Pub Date : 2022-03-01 Epub Date: 2021-10-26 DOI:10.1111/luts.12416

Yoshiyuki Akiyama, Aya Niimi, Yasuhiko Igawa, Akira Nomiya, Yuta Yamada, Yusuke Sato, Taketo Kawai, Daisuke Yamada, Haruki Kume, Yukio Homma

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引用次数: 5

Abstract

Objectives: To evaluate the outcomes of partial and total cystectomy in patients with refractory Hunner-type interstitial cystitis (HIC).

Methods: Patients with end-stage HIC who underwent supratrigonal partial cystectomy with augmentation ileocystoplasty (PC-CP) or total cystectomy with ileal conduit (TC-IC) were identified retrospectively. Changes in the 11-point numerical rating scale of bladder pain and in 7-grade quality of life (QOL) scores were evaluated. Changes in the O'Leary and Sant's Symptom Index (OSSI) and O'Leary and Sant's Problem Index (OSPI) were analyzed in patients with PC-CP. Peri- and postoperative complications and patient satisfaction with overall outcomes were examined.

Results: Four patients (one female) underwent PC-CP and 13 (nine females) underwent TC-IC. Bladder pain persisted in three PC-CP patients, but resolved completely in all TC-IC patients. Pain scale and QOL scores improved significantly in patients with TC-IC (P < .01), but not in those with PC-CP. OSSI/OSPI scores did not improve significantly in patients with PC-CP. Three PC-CP patients required clean intermittent catheterization due to voiding dysfunction or persistent pain. Two TC-IC patients developed stricture of the ureteroileal anastomosis, resulting in permanent placement of a ureteral stent in one case and nephrostomy in the other. Satisfaction rate was higher in the TC-IC than in the PC-CP group (76.9% vs 25.0%, P < .05).

Conclusions: TC-IC provided reliable pain relief and improved QOL in patients with end-stage HIC, but the small case number and limited methodology restrict interpretation of the results. Further studies are needed to identify appropriate candidates and optimal surgical procedures.

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日本三级转诊中心hunner型间质性膀胱炎患者的膀胱切除术。

目的:探讨难治性hunner型间质性膀胱炎(HIC)部分膀胱切除术和全膀胱切除术的治疗效果。方法:回顾性分析行肛上部分膀胱切除术加回肠管成形术(PC-CP)或全膀胱切除术加回肠管成形术(TC-IC)的终末期HIC患者。评估膀胱疼痛的11分数值评定量表和生活质量(QOL)的7分评分的变化。分析PC-CP患者的O'Leary and Sant's Symptom Index (OSSI)和O'Leary and Sant's Problem Index (OSPI)的变化。检查围手术期和术后并发症以及患者对总体结果的满意度。结果:PC-CP 4例(女性1例)，TC-IC 13例(女性9例)。膀胱疼痛在3例PC-CP患者中持续存在，但在所有TC-IC患者中完全缓解。TC-IC患者的疼痛量表和生活质量评分显著改善(P结论:TC-IC为终末期HIC患者提供了可靠的疼痛缓解和生活质量改善，但病例数少，方法有限，限制了对结果的解释。需要进一步的研究来确定合适的候选人和最佳的手术程序。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

LUTS: Lower Urinary Tract Symptoms UROLOGY & NEPHROLOGY-

CiteScore

3.00

自引率

7.70%

发文量

审稿时长

>12 weeks

期刊介绍： LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided. LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.