Bladder replacement by ileocystoplasty: the final treatment

OBJECTIVE: To develop and improve the technique of bladder replacement with ileum in patients with interstitial cystitis. PATIENTS AND METHODS: A consecutive series of 27 patients (23 women and four men, median age 61 years, range 40-79) with chronic severe interstitial cystitis refractory to conservative therapies underwent cystectomy and bladder replacement using an ileal pouch. The relief of pain was assessed over a median follow-up of 30 months (range 2-48). RESULTS: Pain relief was complete in all patients and the median neo-bladder capacity was 520 mL (range 350-700). Only four patients required intermittent self-catheterization to drain post-micturition residual urine. Bladder calculi formed in two patients and were removed successfully at cystoscopy. CONCLUSION: Bladder replacement with ileum in the form of the Kock pouch is an effective surgical treatment for intractable interstitial cystitis.