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Efficacy and safety of urinary diversion in patients with refractory interstitial cystitis/bladder pain syndrome / 中华泌尿外科杂志
Chinese Journal of Urology ; (12): 561-566, 2019.
Article in Chinese | WPRIM | ID: wpr-755487
ABSTRACT
Objective To evaluate the efficacy and safety of urinary diversion in patients with refractory interstitial cystitis/bladder pain syndrome (IC/BPS).Methods Clinical data of 15 female patients who underwent urinary diversion treatment for IC/BPS in our hospital from January 2008 to July 2018 were retrospectively analyzed.The mean age of the subjects was 64 years old (range 29-79),and the mean disease history of IC/BPS was 5 years (range 2-15).Behavior therapy,oral medicine therapy,intravesical instillation,bladder submucosal injection of botulinum toxin type A and sacral neuromodulation showed unsatisfied outcomes in these patients.Before the surgical intervention,the average urinary frequency was (30.7 ± 11.6) per day,the median visual analogue scale (VAS) was 95 (range 50-100),the O'Leary-Sant Index was 35 (range 31-36) [all the interstitial cystitis problem index (ICPI) was 16],the pelvic pain and urgency/frequency patient symptom scale (PUF) was 35 (range 32-36) [the bother score was 12 (range 11-12)],all the quality of life (QOL) was 6,and the average serum creatinine was (81.1 ± 13.5) μmol/L.Two patients underwent cutaneous ureterostomy without cystectomy,1 patient underwent ileal conduit urinary diversion without cystectomy,and the other 12 patients underwent laparoscopic ileal conduit urinary diversion with cystectomy.The differences of the Global Response Assessment (GRA),complications,VAS,ICPI,PUF,QOL and the serum creatinine before and after the operation were compared.Results The mean postoperative follow-up period was 24 months (range 6-110).The last follow-up showed that all the GRA was 7,the median VAS was 0 (range 0-30),all the ICPI was 0,all the PUF(bother score)was 0,and the median QOL was 2 (1-4),which were significantly different with those before the surgery (all P < 0.01).The last follow-up showed that the average serum creatinine was (83.8 ± 12.5)μ mol/L,which were not significantly different with that before the surgery (P =0.22).Postoperative adhesive intestinal obstruction occurred in 3 subjects.Conclusions Urinary diversion might be an effective and adequate treatment for refractory IC/BPS to eliminate pain or lower urinary tract symptom and improve quality of life of the patients.

Full text: Available Index: WPRIM (Western Pacific) Language: Chinese Journal: Chinese Journal of Urology Year: 2019 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Language: Chinese Journal: Chinese Journal of Urology Year: 2019 Type: Article