Cystectomy for Refractory Interstitial Cystitis/Bladder Pain Syndrome: A Retrospective Study from Azerbaijan

Background: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic condition causing persistent bladder-related pain, pressure, or discomfort, significantly impairing quality of life. Cystectomy is a last-resort treatment for severe, refractory cases, but data on outcomes, particularly from specific regions, remain limited. Materials and Methods: This retrospective cohort study analyzed 16 Azerbaijani IC/BPS patients who underwent supratrigonal or total cystectomy between 2014 and 2024. Clinical, radiological, and surgical data were collected, with symptom severity assessed preoperatively and three months postoperatively using the interstitial cystitis symptom index (ICSI), interstitial cystitis problem index (ICPI), and visual analog scale (VAS) for pain. Results: The median age was 57 years, with 75% female. Median symptom duration was 8 years (range: 3-12), anesthetic bladder capacity was 75 mL (range: 40-140), and all patients had Hunner lesions. Surgical interventions included supratrigonal cystectomy with ileal augmentation (12.5%) and simple cystectomy with Bricker ileal conduit diversion (87.5%). Median ICSI scores reduced from 17 (range: 15–19) to 6 (range: 4–8), ICPI from 13 (range: 12–16) to 5 (range: 4–9), and VAS pain scores from 9 (range: 8–10) to 4 (range: 3–5) at the third postoperative month (all p < 0.001). No perioperative complications or in-hospital mortalities occurred, with a median hospital stay of 7 days (range: 6-11). Conclusions: Cystectomy provided substantial symptomatic relief and improved quality-of-life indices in patients with severe, refractory IC/BPS. These findings underscore its role as an effective but complex treatment option for carefully selected patients.