Destruction of the vesicoureteric plexus for the treatment of hypersensitive bladder disorders

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Abstract
Objective To determine whether bilateral vesicoureteric ganglion excision is effective in the treatment of women with hypersensitive bladder disorders. Patients and methods Utilizing neuroconductive studies, 175 women with hypersensitive bladder complaints of burning and frequency were selected by the presence of abnormal pudendal nerve sensory latency studies. Cystoscopy under anaesthesia revealed petechial haemorrhaging peritrigonally with bladder neck involvement, consistent with interstitial cystitis. Results Laser obliteration of the vesicoureteric plexus bilaterally resulted in complete relief of pelvic pain in 112 patients and partial relief in 58. Forty-five patients with complete relief were followed for 2 years with no recurrence of symptoms. Complications included one case of periureteric fibrosis secondary to cauterization. Conclusion Bilateral vesicoureteric ganglion excision offers a new approach to treating hypersensitive bladder disorders such as interstitial cystitis.