The Role of Urinary Diversion for Bladder Pain

Interstitial cystitis/bladder pain syndrome is a complex urologic disorder often managed in a non-operative fashion, but patients with severe symptoms occasionally require surgical intervention. Several approaches to reconstruction have been reported, including trigone-sparing cystectomy with enterocystoplasty, simple cystectomy with diversion, and diversion without cystectomy. While a trigone-sparing approach offers the potential for spontaneous voiding, it leaves bladder and urethral tissue that can cause pain postoperatively. Final choice of surgery is based upon surgeon and patient preference. In recent years, enhanced recovery after surgery (ERAS) protocols modeled after colorectal surgery have been utilized for radical cystectomy postoperative management with success. These approaches can be used for cystectomy for non-malignant cases as well. © 2016, Springer Science+Business Media New York.