The surgical treatment of intractable interstitial cystitis.

Nineteen patients with severe intractable interstitial cystitis were treated surgically with either cecocystoplasty, urinary diversion with or without cystectomy, cystolysis or segmental bladder resection. Of the 6 patients who underwent an augmentation cecocystoplasty 4 were cured and 2 ultimately had urinary diversion before cure. Of the 7 patients who underwent urinary diversion with or without total cystectomy 6 were cured. In the cystolysis group the suprapubic pain was relieved either totally or partially in all 5 cases, and nocturia and urinary frequency were reduced substantially in each. However, only 1 patient was cured completely of all symptoms. The patient who underwent segmental resection of the bladder experienced only temporary symptomatic relief. Postoperative complications included pyocystis in 2 patients who had urinary diversion without cystectomy and hydroureteronephrosis in 1 patient after ureterosigmoidostomy that required multiple procedures. The place for each of these major surgical procedures in the treatment of intractable interstitial cystitis is discussed.