QUESTION: My son has had interstitial cystitis since he was 15yrs old, he is now 33. He has tried all kinds of treatments his urologist has wanted him to try, all kinds of meds,diets, natural meds, you name he's tried it. His pain is excruciating and he has been unable to work since he was about 22. He is married about 12 yrs. Many,many problems because of the IC. His doctor would like him to get a bladder transplant but the thought scares me to death. First off no one can guarantee that it will not get IC as well and it is a very serious operation to go through with no good outlook.Do you have any suggestions or ideas on where we could some better answers,treatments. He simply can't stand the pain any longer and it worries me very much. Thank You Pat


Assuming he has tried all of the conservative treatments including interstim, intravesical instillations, etc., and he still is having intractable pain, then a cystectomy may not be unreasonable.  However, a bladder transplant is another story. It may be likely that removal of the bladder may be reasonable if absolutely every alternative has failed, but I would be very reluctant to recommend a transplant.  He should certainly get an opinion from a tertiary care University center before considering such a major, life-changing surgery.

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QUESTION: What is a cystectomy? And yes he has an interstim,has had more intravesical instillations than I can count IF that is the procedure where the bladder is filled with a solution that stretches the bladder,if not I don't know what that is. Please tell me what is a tertiary care center. I'm sorry I'm asking so many questions but I need to understand what is the best way to proceed at this point.  Thank You  Pat


Cystectomy is the correct technical term for removal of the urinary bladder.  Hydrodistension, where the bladder is filled under anesthesia to stretch it, is different from intravesical therapy where various drugs are placed in the bladder to act on it medically.

A tertiary care center would be a large, university center which typically handles complicated and complex cases such as Mayo Clinic, Cleveland Clinic, Mass. General, etc.  You can ask your local or state medical society where such a center would be close to you.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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