Cystitis glandularis is a benign proliferative disease of the bladder mucosa with a characteristic histopathologic appearance. If a mass lesion is identified, it is resected transurethrally. More extensive surgical management for severe or recurrent cases is poorly characterized in published studies. We present a patient with multiple rapid recurrences of polypoid masses on the trigone causing irritative voiding symptoms. He developed a low-compliance small-capacity bladder and bilateral ureteral obstruction. The patient underwent total cystoprostatectomy with cavernosal nerve sparing and ileal neobladder construction. We advocate such aggressive surgical management in select cases of this disease.