To investigate the long-term therapeutic satisfaction after augmentation enterocystoplasty (AE) or non-AE bladder therapy in patients with Hunner’s interstitial cystitis (HIC).

From 2013 to 2024, patients with cystoscopically confirmed HIC who received AE or non-AE bladder-preserving therapy were retrospectively analyzed. Treatment outcomes were analyzed using the subjective global assessment response, symptoms, and urodynamic parameters. The patients’ symptoms and urodynamic parameters were compared between AE and non-AE groups from baseline to follow-up endpoint.

A total of 54 patients (48 women and 6 men) were included with a mean age of 58.6±11.4 years at diagnosis and a mean follow-up period of 58.6 ± 11.4 years. AE and non-AE therapy was performed in 17 (31.5%) and 37 (68.5%) patients, respectively. A final satisfactory outcome was reported in 13 (76.5%) of the 17 HIC patients after AE and in 26 (70.3%) of the 37 patients after non-AE therapy. Compared with patients who had no improvement, patients who had improved outcomes after AE exhibited decreased interstitial cystitis symptom index (p = 0.007) and visual analog pain scale (p = 0.013) scores and increased bladder fullness sensation (p = 0.002) and cystometric bladder capacity (p = 0.019). Patients who had no improved outcomes after AE did not experience pain relief or increased bladder fullness sensation or bladder capacity. Only 23.4% of the patients treated with AE required repeat surgery or intravesical therapy in the first 1–3 years. By contrast, patients treated with non-AE therapy required repeat intravesical therapy for the recurrence of Hunner’s lesions or bladder symptoms.

Both AE or non-AE therapy can result in satisfactory outcomes in more than 70% of HIC patients. AE provides early relief of bladder pain and increases bladder capacity, and non-AE therapy can also relieve pain and improve functional bladder capacity, resulting in improved outcomes.