Long-term efficacy of minimally invasive surgical treatment in women with primary bladder pain syndrome / interstitial cystitis: five-year follow-up

BACKGROUND: Bladder pain syndrome / interstitial cystitis is a chronic condition characterized by bladder pain and dysuria in the absence of identifiable local abnormalities. Despite its clinical and social significance, data on long-term efficacy of treatment remain limited.

AIM: The work aimed to evaluate the long-term efficacy of minimally invasive surgical treatment in women with bladder pain syndrome.

METHODS: A total of 29 women with bladder pain syndrome refractory to standard conservative therapy were followed up for at least 5 years. Patients were divided into two groups: Group 1 included 20 patients without Hunner’s lesions, and Group 2 included 9 patients with Hunner’s lesions. All patients initially underwent cystoscopy with bladder hydrodistension; in the presence of Hunner’s lesions, laser ablation was performed. Subsequent endoscopic procedures were carried out upon symptom recurrence. Patients without Hunner’s lesions underwent hydrodistension combined with intravesical botulinum therapy, whereas in patients with Hunner’s lesions, these interventions were supplemented by laser ablation.

RESULTS: Treatment efficacy was assessed by analyzing the time intervals between repeated surgical procedures performed in response to worsening bladder pain syndrome symptoms. The mean time interval between interventions in Group 1 was significantly longer than in Group 2 (9.4 ± 1.2 months vs. 6.9 ± 1.0 months). Significant intergroup differences were observed beginning with the time interval between the second and third procedures. Group 1 demonstrated a progressive increase in the duration of these time intervals. No such trend was observed in Group 2. During the long-term 5-year follow-up period, no significant changes in maximum bladder capacity were detected in either group.

CONCLUSION: Minimally invasive surgical treatment for bladder pain syndrome has a high long-term efficacy rate, with no tendency of worsening outcomes. Therapeutic modalities, their sequence, and frequency should be selected on a case-by-case basis.