Therapeutic Effects of Endoscopic Ablation in Hunner Type Interstitial Cystitis Patients

To investigate the efficacy of endoscopic ablation of Hunner lesions (HLs) in patients with interstitial cystitis (IC) and to find predictors of early recurrence of HLs.

A prospective study was performed for Hunner type IC who underwent transurethral ablation. We repeated endoscopic ablation when symptoms and HLs recurred during the follow-up period. The primary endpoint was recurrence-free time. Secondary endpoints were a change of number of frequency, nocturia, and urgency episodes and changes in visual analogue scale for pain and other symptom indices at follow-up visits.

A total of 72 patients were analyzed. The median follow-up period was 29.5 (range, 12.0-50.0) months. After primary ablation treatment, HLs recurred in 75.0% (54/72) of subjects, and the median recurrence-free time was 12.0 ± 1.6 months. Among the 54 patients with recurrence, 50 underwent a second ablation treatment. HLs occurred in 44.0% (22/50) of individuals after the second operation, and the median recurrence-free time was 18.0 ± 5.1 months. Lower maximal cystometric capacity (odds ratio 1.01, 95% CI 1.001-1.013) was the predictive factor for early recurrence. There were significant improvements in the visual analogue scale for pain, O'Leary-Sant interstitial cystitis symptom index and problem index, pelvic pain and urgency/frequency patient symptom scale after treatment (all, p<0.05).

Endoscopic ablation is an effective treatment option for HLs and significantly reduces pain and improves voiding symptoms. Repeat ablation upon recurrence could help symptom control and bladder preservation only if the bladder capacity is maintained. This article is protected by copyright. All rights reserved.

BJU international. 2017 Dec 12 [Epub ahead of print]

Kwang Jin Ko, Hyunwoo Chung, Yoon Seok Suh, Sin Woo Lee, Tae Heon Kim, Kyu-Sung Lee

Department of Urology Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea., Department of Urology Center for Prostate Cancer, Research Institute and Hospital of the National Cancer Center, Goyang, Korea., Department of Urology, Gyeongsang National University Hospital, Jinju, Korea.