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Urinary diversion in the treatment of refractory bladder pain syndrome.

08:00 EDT 13th August 2019 | BioPortfolio

Summary of "Urinary diversion in the treatment of refractory bladder pain syndrome."

This study investigates the effect of urinary division in patients with bladder pain syndrome (BPS) refractory to conservative treatment. This study aimed to identify pre-operative predictive factors regarding the surgical outcome in patients undergoing urinary diversion with or without cystectomy (CX). This study included 30 patients with BPS treated with a urinary diversion in the period from 2002-2017 at a single university hospital. The surgical procedure was selected on an individual basis, including both continent and non-continent diversions and primary procedure with or without concomitant CX. Pre- and post-operative data were registered retrospectively through medical chart review. Eight patients were treated with primary CX and eight had secondary CX within a short time following urinary diversion (1.45 years in median), mainly due to persisting pain. However, more than half the patients were successfully treated with urinary diversion alone throughout the follow-up period (estimated 58% after 12 years). Nine patients were prior to surgery diagnosed with Hunner's lesions, and these had significantly greater pain relief compared to the remaining 21 patients ( = 0.02). The higher success rate of the bladder-preserving procedure was suggested in patients older than 48 years ( = 0.09) with less pain pre-operatively, estimated by less than three opioids prior to the procedure ( = 0.01). Surgical treatment with urinary diversion should be taken into consideration for refractory BPS, especially patients diagnosed with Hunner's lesions. These results support a bladder-preserving strategy unless the patient is young or has severe treatment refractory pain pre-operative.

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This article was published in the following journal.

Name: Scandinavian journal of urology
ISSN: 2168-1813
Pages: 1-7

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Medical and Biotech [MESH] Definitions

Temporary or permanent diversion of the flow of urine through the ureter away from the URINARY BLADDER in the presence of a bladder disease or after cystectomy. There is a variety of techniques: direct anastomosis of ureter and bowel, cutaneous ureterostomy, ileal, jejunal or colon conduit, ureterosigmoidostomy, etc. (From Campbell's Urology, 6th ed, p2654)

An artifical implanted device, usually in the form of an inflatable silicone cuff, inserted in or around the bladder neck in the surgical treatment of urinary incontinence caused by sphincter weakness. Often it is placed around the bulbous urethra in adult males. The artificial urinary sphincter is considered an alternative to urinary diversion.

A HERNIA-like condition in which the weakened pelvic muscles cause the URINARY BLADDER to drop from its normal position. Fallen urinary bladder is more common in females with the bladder dropping into the VAGINA and less common in males with the bladder dropping into the SCROTUM.

Symptom of overactive detrusor muscle of the URINARY BLADDER that contracts with abnormally high frequency and urgency. Overactive bladder is characterized by the frequent feeling of needing to urinate during the day, during the night, or both. URINARY INCONTINENCE may or may not be present.

Structures which collect and store urine and are emptied by catheterization of a cutaneous stoma or internal diversion to the urethra. The reservoirs are surgically created during procedures for urinary diversion.

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