To assess the clinical impact of Hunner lesions in patients with Hunner type interstitial cystitis (HIC).
The clinical records of 94 HIC patients who underwent their first hydrodistension (with lesion fulguration) were retrospectively reviewed. At surgery, the extent of each lesion was classified in terms of the relative involvement for the whole-bladder luminal surface; we defined four grades of involvement: <10%, 10-24%, 25-49%, and ≥50%; and two grades of severity: <25% (focal) and ≥25% (extensive). We examined the relationships between the extent of the lesions and all demographic characteristics, symptom scores, voiding symptoms, and bladder capacity. Factors predictive of the need for repeat hydrodistension were also explored.
Symptom severity worsened as the lesional extent rose. Those with extensive lesions scored higher on the O'Leary and Sant Symptom (P = 0.004) and Problem Index scales (P < 0.001), the pain visual analog scale (P = 0.011), the International Prostate Symptom Score scale (P = 0.012), and a quality-of-life index (P = 0.020); and exhibited greater daytime urinary frequency (P = 0.040), more nocturia (P = 0.041), and a smaller bladder capacity (P = 0.007) than the focal group. No symptomatic or clinical parameters predicted the need for repeat hydrodistension.
The extent of Hunner lesions was associated with both symptom severity and bladder capacity but not with other clinical parameters, including the need for repeat hydrodistension, in patients with HIC.
Neurourology and urodynamics. 2018 Jan 09 [Epub ahead of print]
Yoshiyuki Akiyama, Aya Niimi, Akira Nomiya, Yukio Yamada, Tohru Nakagawa, Tetsuya Fujimura, Hiroshi Fukuhara, Haruki Kume, Yasuhiko Igawa, Yukio Homma
Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Department of Urology, Teikyo University School of Medicine, Tokyo, Japan., Department of Urology, National Center for Global Health and Medicine, Tokyo, Japan., Department of Continence Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.