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Ulcer Surgery Procedure for the Bladder

Interstitial cystitis is a condition that causes pain in the bladder and pelvic area. In some cases, bladder pain is caused by star-shaped ulcers in the bladder wall called Hunner's ulcers. According to the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC), about 10 percent of people with interstitial cystitis have Hunner's ulcers. If medication and other less-invasive procedures, such as bladder distention, fail to control debilitating pain, a doctor may consider a surgical procedure on bladder ulcers.

  1. Fulguration and Resection

    • These are both procedures that doctors can do with surgical instruments inserted through the urethra into the bladder. General anesthesia is used for both procedures. A surgeon burns Hunner's ulcers with a laser or electricity during a fulguration procedure. Once the burned area heals, the burned tissue and ulcer fall off to expose healthy tissue underneath. During a resection, a surgeon cuts around Hunner's ulcers to remove them completely through the urethra in small pieces.

    Augmentation

    • Augmentation makes the bladder larger. Usually, a surgeon removes any ulcers and damaged tissue from the patient's bladder. The surgeon then attaches a reshaped piece of the large intestine, or colon, to the base of the bladder where healthy tissue remains. Augmentation procedures help patients urinate less often once the incision heals. The procedure also helps relieve pain in some patients with interstitial cystitis, but pain can return in the section of colon attached to the bladder.

    Cystectomy

    • A cystectomy is a surgical procedure in which the entire bladder is removed. A cystectomy is a last-resort procedure that most doctors perform infrequently. After a cystectomy, patients must void urine in alternative methods. Most cystectomy patients empty urine from a hole in the abdomen called a stoma into a bag. The surgeon creates ureters, tubes to carry urine, to a piece of the colon that leads to the stoma. Some surgeons attach a pouch to store urine inside the abdomen. Patients who have a pouch must attach a catheter into the hole in the abdomen to empty the pouch several times a day. A few surgeons with special training can create a new bladder from a section of the colon and attach it to the urethra. The patient can then urinate at prescheduled times or insert a catheter into the urethra to void urine.

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