Presentation Authors: Joao Zambon*, Kshipra Hemal, Robert Evans, Gopal Badlani, Steve Walker, Andre Plair, Whitney Smith, Candice Parker-Autry, Catherine Matthews, Winston Salem, NC
Introduction: Cystectomy is a final therapeutic option for patients with refractory interstitial cystitis/bladder pain syndrome (IC/BPS) and low bladder capacity (BC < 400cc). This study assessed the quality of life, body image, and sexual function in female patients with IC/BPS who underwent cystectomy.
Methods: This is a single center study performed from 2015 to 2018, which enrolled women older than 18 years old with refractory IC/BPS and BC < 400 cc who underwent simple cystectomy according to AUA guidelines. Quality of life was evaluated by the patient global impression improvement (PGII) questionnaire and patientâ€™s body image impression following cystectomy. Sexual function was assessed using a validated questionnaire, the patient-reported outcomes measurement information system sexual function and satisfaction questionnaire (PROMIS-SFQ).
Results: The study enrolled 23 patients with mean age 52 + 15 years and mean postoperative follow up 25 + 7 months. All patients underwent open cystectomy with vaginal length preservation and ileal conduit diversion. Twenty patients (87%) reported improvement in suprapubic pain and overall quality of life (p=0.037). PGII were inversely correlated with age (p=0.012). Ileal conduit had higher impact on body image of younger patients (p=0.006) and patients with shorter follow up (p=0.03). Postoperative sexual activity was reported by seven patients (30%). All sexually active women reported vulvar and vaginal discomfort during sexual intercourse (p=0.049). Lack of interest (59%), vaginal dryness (17%), and difficult to achieve orgasm (7%) were the main sexual-related complaints (p=0.017).
Conclusions: Simple cystectomy in female patients with IC/BPS and low BC improves pain symptoms and quality of life. However, sexual function appears to be adversely affected. This information should be utilized for pre-operative surgical counseling.