Endoscopic ablation of Hunner's lesions in interstitial cystitis patients

Abstract

Introduction: We report our experience with endoscopic ablation of Hunner's lesions in women with interstitial cystitis (IC). Methods: A chart review was performed on 14 patients with IC symptoms who were identified to have bladder lesions and under- went endoscopic ablation. A Hunner's lesion was identified as an area of erythema that reproduced the patients' pain when touched by the cystoscope. Pathology reports were reviewed and improve- ment in pain was used as the main outcome measure. Results: Of the 14 patients, 12 had more than 50% symptomatic improvement and 8 patients reported 100% improvement. Mean improvement was 76%. In all patients who improved, the biopsy specimen showed inflammatory cystitis, often with epithelial denudation. Four patients had symptomatic recurrence, but all had improvement after repeat ablation. Conclusion: Endoscopic ablation of Hunner's lesions improves symp- toms in IC patients. Recurrence of symptoms should prompt repeat cystoscopy to identify recurrent lesions, as repeat ablation offers symptomatic improvement. © 2009 Canadian Urological Association.