Enterocistoplastia por cistitis intersticial. Resultados diferidos

Resumen

Introducción

La cistitis intersticial es de diagnóstico clínico, caracterizada por síntomas irritativos vesicales y dolor suprapúbico. Se reporta hasta 10% de pacientes que la padecen son refractarios al manejo conservador. En estos, la cistectomía supratrigonal más ampliación vesical es una opción.

Objetivo

Evaluar los resultados obtenidos en nuestra serie de pacientes sometidos a esta técnica quirúrgica por padecer cistitis intersticial refractaria a tratamiento conservador.

Material y métodos

Se revisan los pacientes sometidos a cistectomía supratrigonal más enterocistoplastia de aumento por cistitis intersticial refractaria a tratamiento conservador en nuestro hospital entre 1999 y 2006. Se consignan ritmo miccional pre y post-operatorios, capacidad vesical preoperatoria medida durante cistodistensión y post-operatorias medida en volumen miccional, complicaciones de la cirugía y grado de satisfacción de los pacientes medida mediante aplicación de encuesta. Se compara ritmos miccionales y capacidad vesical pre y postoperatorias.

Resultados

Se realizó 15 intervenciones. Capacidad vesical preoperatoria X: 125 cc, ritmo miccional preoperatorio promedio 30,5 veces/día. Hubo complicaciones perioperatorias en 5 pacientes. El volumen miccional post operatorio promedio es 355 cc y la frecuencia 8,26. Al comparar los ritmos y el volumen urinario pre y postoperatorio existe diferencias estadísticamente significativas (p: 0,0008 y p: 0,0007 respectivamente). Al momento de la entrevista 13 pacientes se encontraban satisfechos con su frecuencia miccional y 11 por la mejoría en el dolor suprapúbico.

Abstract

Introduction

Interstitial cystitis is clinically diagnosed entity, characterized by irritative bladder symptoms and suprapubic pain. It is reported that up to 10% of patients are refractory to conservative management. In these patients’ supratrigonal cystectomy and bladder enlargement enterocystoplasty has been used.

Objective

To evaluate the results of our series of patients that underwent this surgical technique due they were suffering interstitial cystitis refractory to conservative treatment.

Materials and Methods

We reviewed the medical records of patients that underwent supratrigonal cystectomy and bladder enlargement enterocystoplasty in our hospital between 1999 and 2006. Mictional rhythm, pre and postoperative bladder capacity measured by cystodistention, postoperative bladder capacity measured as mictional volume, surgical complications and the degree of satisfaction of patients measured by means of application of a survey were recorded. Mictional rhythms and pre and postoperative bladder capacity were compared.

Results

15 interventions were performed. Mean preoperative bladder capacity was 125 cc, Mean preoperative mictional rhythm was 30.5 times a day. There were perioperative complications in 5 patients. The mean postoperative mictional volume was 355 cc and mean frequency was 8.26. When comparing pre and postoperative rythms and urinary volume there were statistically significant differences (p:0.0008 y p:0.0007 respectively). Regarding the survey, 13 patients were satisfied in terms of mictional frequency and 11 patients were satisfied in terms of suprapubic pain.