Doctors consider surgery for interstitial cystitis (IC) as a last resort when other treatments, such as diet changes, medications, bladder instillations, and physical therapy, have failed to bring relief.
Most people with IC, also called bladder pain syndrome (BPS), do not need surgery, but in severe, persistent cases, it may be an option.
Bladder surgery is an option for interstitial cystitis, but in
A urologist who specializes in IC typically only recommends surgery after extensive evaluation, as it does not guarantee symptom relief and can have serious, life changing consequences.
A person should discuss all risks and benefits thoroughly with a medical professional before considering surgery.
Below are some
Bladder hydrodistention
In this minimally invasive procedure, the person is given anesthesia, and a surgeon fills the bladder with fluid to stretch it. This may provide temporary symptom relief, though it does not offer a cure.
Fulguration or resection
When patients have inflammatory patches in the bladder called Hunner’s lesions, surgeons may burn (fulgurate) or cut (resect) these areas to reduce pain.
Neuromodulation
Doctors may implant a sacral nerve stimulator, which works like a bladder pacemaker, to help regulate bladder function and ease pain and urgency.
Bladder augmentation
Surgeons enlarge the bladder using a segment of the intestine. This can lower bladder pressure and relieve pain, but it may also cause complications, such as requiring self-catheterization.
Self-catheterization is a process in which a person inserts a thin, flexible tube called a catheter into their bladder through the urethra to drain urine.
Urinary diversion
In severe cases, surgeons may bypass or remove the bladder. Bladder removal is known as a cystectomy. They reroute urine through a stoma or create a new urinary pathway using part of the intestine.
Doctors reserve this option for situations where disabling pain persists despite all other treatments.
Surgery for interstitial cystitis (IC), also known as bladder pain syndrome (BPS), is typically a last resort after other treatments have failed.
While surgical interventions can provide symptom relief for some patients, outcomes vary depending on the specific procedure and individual patient factors.
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In cases involving a cystectomy and urine diversion, studies have shown that 74% of patients reported being pain-free postsurgery, with a satisfaction rate of 68%.
Surgical interventions carry inherent risks, including potential complications and the possibility of persistent symptoms.
Therefore, thorough preoperative evaluation and patient selection are crucial. Patients should discuss the potential benefits and risks of surgery with a healthcare professional to determine the most appropriate course of action.
Some possible risks of surgery include:
- Infection: As with any surgical procedure, there is a risk of infection at the surgical site or within the urinary tract.
- Bleeding: Blood loss may occur during surgery, especially in procedures involving extensive tissue removal.
- Pain: Postoperative pain is common and may persist or even worsen in some individuals.
- Anesthesia complications: General anesthesia carries risks such as allergic reactions, respiratory issues, or cardiovascular complications.
Each surgery has its own specific risks, so it is best to get a detailed overview of risks from a healthcare professional.
A surgeon will run through exactly what to expect from their specific surgery, including preparation and recovery. In general, a person can expect the following.
Before surgery
Doctors begin by evaluating the patient’s symptoms, medical history, and previous treatments. They often order tests such as cystoscopy, urodynamics, or imaging studies to assess bladder health.
Pre-surgical counseling follows, during which the surgeon explains the available surgical options, potential risks and benefits, and the reasons for considering surgery over conservative treatments.
Patients typically undergo preoperative testing, which may include blood and urine tests and an anesthesia evaluation.
Physicians may instruct patients to stop certain medications, fast before surgery, or complete bowel preparation if the procedure involves the intestines. In addition, arrangements for postoperative transportation and support at home are usually necessary.
During surgery
The surgical experience varies depending on the procedure. Minimally invasive options, such as bladder hydrodistention or fulguration, are generally performed under general or spinal anesthesia on an outpatient basis.
More invasive surgeries, such as bladder augmentation or cystectomy, require general anesthesia and take several hours.
These procedures usually involve a hospital stay of three to seven days. Surgeons may insert a urinary catheter or create a stoma, depending on the operation.
After surgery
In the immediate postoperative period, patients may experience pelvic pain, urinary urgency, or minor bleeding. A catheter often remains in place for several days. Physicians commonly prescribe pain medications and antibiotics to manage discomfort and prevent infection.
Following major surgery, the hospital team monitors for signs of infection, assesses bowel function, and ensures the patient can urinate or manage any urinary diversion. Staff provide education on catheter or stoma care when applicable.
Recovery at home depends on the type of surgery. Minor procedures such as hydrodistention generally require only a few days of recovery, while major surgeries like bladder augmentation may take several weeks. Doctors provide specific instructions for rest, wound care, physical activity, and follow-up visits.
In the long term, patients often continue to receive monitoring of bladder function and may benefit from additional treatments, including physical therapy or lifestyle modifications. Regular follow-up visits help detect any complications or recurrence of symptoms.
Surgery for IC is typically considered only after other treatments have failed to provide relief.
Options range from minimally invasive procedures like bladder hydrodistention and lesion removal to more extensive surgeries such as bladder augmentation or urinary diversion.
These interventions aim to reduce pain, improve bladder capacity, and manage symptoms, but they are not cures and carry potential risks, including infection and inconsistent results.
Outcomes vary, and major surgeries are reserved for severe cases where symptoms significantly impact quality of life. Careful evaluation and long-term follow-up are essential components of surgical management for IC.