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.


Journal Details

This article was published in the following journal.

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


DeepDyve research library

PubMed Articles [25823 Associated PubMed Articles listed on BioPortfolio]

Bladder Hydrodistention Does Not Result In a Significant Change In Bladder Capacity For Interstitial Cystitis/Bladder Pain Syndrome Patients.

To assess the impact of multiple (two or more) bladder hydrodistentions (HODs) on anesthetic BC in a large cohort of IC/BPS patients. Urinary bladder hydrodistention (HOD) under anesthesia is a third ...

Utility of robot-assisted radical cystectomy with intracorporeal urinary diversion for muscle-invasive bladder cancer.

Radical cystectomy remains the gold standard for treatment of muscle-invasive bladder. Robot-assisted radical cystectomy has technical advantages over laparoscopic radical cystectomy and has emerged a...

Development of a goal elicitation measure to support bladder cancer patients' choice about urinary diversion.

Patient-centered care aims to align treatment with patient goals, especially when treatment options have equivalent clinical outcomes. For surgeries with lasting impacts, that alignment is critical. N...

Long-term neurogenic lower urinary tract dysfunction: A case of cardiovascular nightmares.

Individuals with spinal cord injury (SCI) suffering from autonomic dysreflexia (AD) due to neurogenic detrusor overactivity (NDO) can effectively be treated with intradetrusor onabotulinumtoxinA. We p...

Urinary fungi associated with urinary symptom severity among women with interstitial cystitis/bladder pain syndrome (IC/BPS).

To correlate the presence of fungi with symptom flares, pain and urinary severity in a prospective, longitudinal study of women with IC/BPS enrolled in the MAPP Research Network.

Clinical Trials [19456 Associated Clinical Trials listed on BioPortfolio]

Comparison of the Treatment of Refractory Bladder Pain Syndrome With DMSO and DMSO With Botulinum Toxin A

The purpose of this research study is to evaluate the efficacy of intravesical botulinum A toxin and DMSO in women with bladder pain syndrome who have not responded to first-line treatment...

A Comparison of the Studer Pouch Versus the T-Pouch Orthotopic Neobladder Urinary Diversion in Bladder Cancer Patients

This is a prospective, randomized study of two types of continent ileal neobladder construction in patients undergoing cystectomy for primary bladder cancer. Patients will be randomly assi...

Intra-corporal vs Extra-corporal Urinary Diversion After Robot Assisted Radical Cystectomy

Intracorporal urinary diversion (ICD) provides superior postoperative outcomes compared to extracorporal urinary diversion (ECD). The investigators' hypothesis that ICD may provide clinica...

Botulinum a Toxin to Treat Patients With Painful Bladder Syndrome

Botulinum A toxin (BoNT/A) injections in patients with painful bladder syndrome (PBS) associated with increased urinary frequency refractory to conventional treatments versus bladder over ...

Intravesical Injection of Botox for Treating Therapy Refractory Overactive Bladder in Females

The neurotoxin Botox (botulinum neurotoxin type A) is shown to be effective in the treatment of therapy refractory overactive bladder syndrome. Our data suggests a longer during efficacy t...

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.

Quick Search

DeepDyve research library

Relevant Topics

Benign Prostatic Hyperplasia (BPH) Erectile Dysfunction Urology Urology is the branch of medicine concerned with the urinary tract and diseases that affect it. Examples include urethritis, urethrostenosis and incontinence. Urology is a su...

Bladder Cancer
Non-invasive bladder cancer is a cancer that is only in the inner lining of the bladder. Invasive bladder cancer is cancer that has spread into the deeper walls of the bladder. When the cancer has spread outside the bladder to other parts of the body, th...

Pain is defined by the International Association for the Study of Pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage”. Some illnesses can be excruci...

Searches Linking to this Article