Bladder distention surgery, also known as hydrodistention, is most often used to improve symptoms in people with interstitial cystitis. Interstitial cystitis results from inflammation of the bladder wall, which may stiffen, bleed and ulcerate. Interstitial cystitis causes bladder spasms, pain and extremely frequent urination, up to 60 times a day, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Hydrodistention appears to interfere with transmission of pain signals from nerves and also increases bladder capacity. As with any medical procedure, complications can occur.
Hematuria
In bladder distention surgery, the bladder is filled with sterile water or saline and distended for varying time periods. The fluid then drains from the bladder. Blood in the urine at the end of the drainage procedure commonly occurs. If ulcers in the bladder wall rupture when the bladder walls are distended, heavy bleeding can occur when the pressure is removed from the walls, according to lead author Yukio Homma of Japan in the July 2009 issue of "International Journal of Urology."
Bladder Rupture
Bladder rupture can complicate bladder distention surgery. If bladder rupture is suspected, cystogram, an X-ray of the bladder using contrast dye, should be done to assess the bladder walls. If the rupture leaks fluid into the peritoneal cavity, exploratory surgery and repair are necessary to prevention peritonitis, or infection in the cavity. If the leakage is contained outside the peritoneal cavity, insertion of a Foley catheter allows spontaneous healing of the bladder, according to "Glenn's Urologic Surgery" published by Lippincott Williams & Wilkins in 2009.
Bladder Necrosis
Bladder necrosis is a rare but serious complication of bladder distention surgery. Lead author and urologist Nasim Zabihi, M.D., reported on three cases of bladder necrosis after bladder distention at two separate institutions in the January 2007 issue of the "Journal of Urology." All had previously been treated with hydrodistention and all had interstitial cystitis. All had severe postoperative abdominal pain and required cystectomy, bladder removal, followed by enterocystoplasty, surgical creation of a new bladder using part of the bowel.
Infection
Urinary tract infection can occur after bladder hydrodistention. Patients should have a sterile bladder before performing the procedure. Preoperative antibiotics help decrease the risk of postoperative infection.
Temporary Worsening
Symptoms may worsen for four to forty-eight hours after the procedure but then improve within two to four weeks, the National Institute of Diabetes and Digestive and Kidney Disorders explains.
References
- The Journal of Urology: Bladder Necrosis Following Hydrodistention in Patients With Interstitial Cystitis; Nasim Zabihi; January 2007
- "Glenn's Urologic Surgery": Lipincott Williams and Wilkins; 2009
- International Journal of Urology: Clinical guidelines for Interstitial Cystitis and Hypersensitive Bladder Syndrome; Yukio Homma; June 2009
- National Institute of Diabetes and Digestive and Kidney Disorders: Interstitial Cystitis
- Urology Surgery: Interstitial Cystitis
