A Systematic Review of Surgical interventions for the Treatment of Bladder Pain Syndrome/Interstitial Cystitis

Osman, Nadir I.; Bratt, D; Downey, Alison; Esperto, Francesco; Inman, Richard; Chapple, Christopher R.

doi:10.1016/j.euf.2020.02.014

Cited by 40 publications

(37 citation statements)

References 40 publications

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“…The multifaceted effects of this disease demand a holistic treatment approach, based on a biopsychosocial model, which reflects the non-specific phenotypes. A plethora of therapies exist in current clinical practice and these range from conservative approaches to reconstructive surgery [6,7]. Among this treatment catalogue, exists intravesical therapies, which typically represent the next step in the treatment algorithm when conservative measures and pharmacotherapy have failed.…”

Section: Manuscriptmentioning

confidence: 99%

Current Status of Intravesical Therapies for Bladder Pain Syndrome (BPS): A Narrative Review of Emerging Evidence

Jones

Hjelle

Mohn

et al. 2021

Urology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Manuscriptmentioning

confidence: 99%

Current Status of Intravesical Therapies for Bladder Pain Syndrome (BPS): A Narrative Review of Emerging Evidence

Jones

Hjelle

Mohn

et al. 2021

Urology

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“…However, even leaving only vestigial bladder muscle, persistent painful bladder was still present. Webster et al reported complete painful relief after additional removal of the trigone in patients submitted to supratrigonal cystectomy and enterocystoplasty for treating IC/PBS (41)(42)(43). In fact, urinary incontinence after a neobladder operation depends on creating adequate storage reservoir and preserving the sphincteric mechanism.…”

Section: Sexual Function and Quality Of Life In Women After Radical Cystectomy For Non-malignant Bladder Conditionsmentioning

confidence: 99%

The impact of orthotopic reconstruction on female sexuality and quality of life after radical cystectomy for non-malignant bladder conditions

Borghi

Manservigi

Milandri

et al. 2021

Arch Ital Urol Androl

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Objective: To review the literature on the impact on female quality of life and sexual function of orthotopic reconstruction after radical cystectomy for non-malignant bladder conditions. Radical cystectomy is commonly required to treat malignant conditions but may also be considered for the treatment of non-malignant diseases. These heterogeneous group of disorders includes interstitial cystitis, painful bladder syndrome, neurogenic bladder, haemorrhagic/ radiation cystitis, endometriosis and refractory genitourinary fistula. Treatment begins with non-invasive medical therapies but, in non-responder cases, a surgical solution should be considered. Such invasive techniques include urinary diversion and reconstructive procedures that have an impact on healthrelated quality of life, physical, social, and mental status. Materials and methods: This narrative review research was done using the PubMed database up until 2020, July. All papers referring to cystectomy for benign indication were considered. Results: In comparison to other reconstructive options, orthotopic neobladder allows the restoration of a normal self-image and consequently it is the most suitable procedure when a surgical reconstruction is necessary for non-malignant conditions. However, women can face many disorders that impact on everyday life, such as voiding dysfunction or sexual activity problems. Conclusions: Scant data is available about quality of life, sexual life and self-perception in women treated by cystectomy for benign conditions and most literature is dedicated to those indicators in cancer patients. More research is needed to understand the tolerability and the quality of life results of the female population affected by benign conditions undergoing this kind of surgical approach.

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“…A recent systematic review of 448 BPS patients from 20 studies, undergoing radical surgery found that 77% of patients reported symptomatic improvement and the highest clinical response was observed in patients who underwent total cystectomy with orthotopic neobladder formation. 75 Other procedures performed included subtotal cystectomy with cystoplasty and urinary diversion alone. 6.9% of patients underwent a follow-up surgical procedure (total cystectomy ± ileal conduit) and almost half of those patients subsequently improved.…”

Section: Major Surgerymentioning

confidence: 99%

<p>Clinical Management of Bladder Pain Syndrome/Interstitial Cystitis: A Review on Current Recommendations and Emerging Treatment Options</p>

Colemeadow¹,

Sahai²,

Malde³

2020

RRU

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Bladder pain syndrome (BPS) is a chronic condition characterized by pelvic pain or pressure which is perceived to be originating from the bladder, accompanied by one or more urinary symptoms, including frequency, urgency and nocturia. The precise etiology of BPS is not fully understood. Chronic bacterial infection, defective glycosaminoglycan (GAG) layer of the bladder urothelium, inappropriate activation of mast cells in the suburothelial layer of the bladder, autoimmune-mediated mechanisms and autonomic nervous system dysfunction have all been implicated. Treatments targeted at each of these mechanisms have been developed with mixed outcomes. High-quality research into the treatment options is lacking and it is difficult to draw definite conclusions. The treatment approach is multimodal and should be patient specific, targeting the symptoms which they find most bothersome. Conservative treatment, including patient education, behavioural modification, dietary advice, stress relief and physical therapy is an essential initial management strategy for all patients. If no response is observed, oral treatments such as amitriptyline are likely to offer the greatest response. Cystoscopy is essential to phenotype patients, and Hunner lesion directed therapy with fulguration or resection can be performed at the same time. Intravesical instillation of DMSO or lidocaine, detrusor injections of botulinum toxin A and neuromodulation can be used if initial management fails to improve symptoms. Oral cyclosporin can be trialled in those experienced with its use; however, it is associated with significant adverse events and requires intense monitoring. Lastly, radical surgery should be reserved for those with severe, unremitting BPS, in which quality of life is severely affected and not improved by previously mentioned interventions. Future work investigating exact aetiological factors will help target the development of efficacious treatment options, and several promising oral and intravesical treatments are emerging.

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A Systematic Review of Surgical interventions for the Treatment of Bladder Pain Syndrome/Interstitial Cystitis

Cited by 40 publications

References 40 publications

Current Status of Intravesical Therapies for Bladder Pain Syndrome (BPS): A Narrative Review of Emerging Evidence

Current Status of Intravesical Therapies for Bladder Pain Syndrome (BPS): A Narrative Review of Emerging Evidence

The impact of orthotopic reconstruction on female sexuality and quality of life after radical cystectomy for non-malignant bladder conditions

<p>Clinical Management of Bladder Pain Syndrome/Interstitial Cystitis: A Review on Current Recommendations and Emerging Treatment Options</p>

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