Surgical Therapy of Bladder Pain Syndrome
Endoscopic techniques have been used extensively, however with mixed results, but are generally accepted now, when more selectively applied, taking the importance of adequate phenotyping of BPS/IC into account. Neurosurgical procedures have a decreasing role. Major surgery has an important but limited role; the various procedures are extensive and in principle irreversible for a condition that otherwise implies a very modest risk of death or life-threatening complications. Many factors must be taken into account. Apart from the more immediate problems intra- and postoperatively, there are less obvious ones like metabolic consequences  and the late development of cancer after incorporation of bowel into the urinary tract . Since 1990 the attitude has not changed but rather been strengthened: reconstructive procedures have been and are still to be regarded as last resorts, to be used very selectively when there is nothing else with reasonable efficacy to be offered.
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