The management of chronic interstitial cystitis by substitution cystoplasty.

A total of 19 patients with interstitial cystitis symptoms intractable to conservative management underwent supratrigonal excision of the symptomatic bladder. Reconstruction to produce a low pressure reservoir was accomplished with a segment of remodeled intestine anastomosed to the bladder remnant. Patients were selected because of a history of typical intractable severe symptoms in the presence of characteristic endoscopic features. Of the patients 12 were cured of the pain and frequency, 4 experienced improvement, and 3 failed to improve and underwent urinary diversion. Preoperative features did not predict the outcome, although poor results occurred more often in those with large preoperative bladder capacities while under anesthesia and those who had postoperative voiding problems requiring self-catheterization.