Endoscopic Injection of Low Dose Triamcinolone: a Simple, Minimally Invasive and Effective Therapy for Interstitial Cystitis with Hunner Lesions

To investigate the efficacy of low dose triamcinolone injection for effectiveness and durability in interstitial cystitis/bladder pain syndrome (IC/BPS) patients with Hunner Lesions (HL).

Clinical data from patients with HL who underwent endoscopic submucosal injection of triamcinolone were reviewed: Demographics, pre/post operative pain and nocturia scores, and long-term clinical outcomes were assessed. Duration of response was estimated by time to repeat procedure. Kaplan-Meier estimator was used to evaluate time to repeat procedure.

36 patients who received injections of triamcinolone between 2011 and 2015 were included. Median age±SD of patients was 61.5±12.0 years 23; 28 (77.8%) of patients were female and 8 (22.2%) were male. 26 patients (72.2%) received only 1 set of injections, 8 (22.2%) received 2 sets of injections, and 2 (5.56%) received 3 or more sets of injections. Average time between injections in those receiving more than one set of injections was 344.9 days (median: 313.5, range: 77-714). Pre-procedural pain scores were 8.3±1.2 (mean±SD) on Likert pain scale (0-10), and mean post-procedural pain scores at approximately one month were 3.8±2.2 p<0.001. Mean pre-procedural nocturia bother scores were 7.5±2.0 and mean post-procedural nocturia bother scores were 5.1±2.5) p<0.001.

Endoscopic submucosal injection of low dose triamcinolone in IC/BPS patients with HL is an effective and durable adjunct to existing treatment modalities. This approach is associated with low morbidity and can be performed on an outpatient basis.

Urology. 2018 May 18 [Epub ahead of print]

Michael G Funaro, Alexandra N King, Joel N H Stern, Robert M Moldwin, Sonia Bahlani

Hofstra Northwell School of Medicine, Hempstead, NY. Electronic address: ., Hofstra Northwell School of Medicine, Hempstead, NY., Hofstra Northwell School of Medicine, Hempstead, NY; Department of Autoimmunity, The Feinstein Institute for Medical Research, Northwell Health System, Manhasset, NY, USA., Hofstra Northwell School of Medicine, Hempstead, NY; Arthur Smith Institute for Urology, Northwell Health, New Hyde Park, NY.