Electrosurgical management of Hunner ulcers in a referral center's interstitial cystitis population.

Abstract

OBJECTIVE:

To characterize electrocautery (EC) as a valid treatment option in interstitial cystitis (IC) patients with Hunner ulcers (HUs).

METHODS:

From 1997 to 2013, a single urologist's IC population was retrospectively reviewed to identify HU patients as well as their demographics, operative characteristics, and response to a 2-page questionnaire evaluating parameters of their experience with EC. Descriptive statistics, Pearson chi-square test, Student t test, and Pearson coefficient were used.

RESULTS:

Two hundred fourteen EC procedures were performed in 76 patients (87% women; mean age, 66 ± 1.67 years). Fifty-one patients (69%) who underwent multiple EC had mean initial bladder capacity of 438.62 ± 27.90 mL and final bladder capacity of 422.40 ± 30.10 mL. Mean number of EC procedures was 2.98 ± 0.25 (range, 1-11). Mean time between sessions was 14.52 ± 1.34 months (range, 1-121 months). Fifty-two patients (68%) completed our questionnaire, with 13.54 ± 1.28 years of symptoms and 10.66 ± 0.96 years since diagnosis. Ranking IC treatments, 37 patients (84%) reported EC most beneficial. On a 0-10 (none to worst possible) scale before and after EC, frequency improved from 9.04 ± 1.30 to 3.65 ± 2.75 (P <.001), urgency from 8.40 ± 2.38 to 3.28 ± 2.71 (P <.001), and pain from 8.62 ± 2.36 to 2.68 ± 2.55 (P <.001). Overall, 89.6% of patients noted some degree of symptom improvement after EC; 56.3% of patients had marked improvement. A total of 98% of patients would undergo EC again.

CONCLUSION:

EC of HU is an effective and safe procedure with high patient satisfaction that does not diminish bladder capacity.

• Authors: Avinash Chennamsetty, Iyad Khourdaji, Jonathan Goike, Kim A Killinger, Benjamin Girdler, Kenneth M Peters
• Journal: Urology (Urology) Vol. 85 Issue 1 Pg. 74-8 (Jan 2015) ISSN: 1527-9995 [Electronic] United States
• PMID: 25440759 (Publication Type: Journal Article)
• Copyright: Copyright © 2015 Elsevier Inc. All rights reserved.

Topics

• Aged
• Cystitis, Interstitial (complications)
• Electrocoagulation
• Female
• Humans
• Male
• Referral and Consultation
• Retrospective Studies
• Surveys and Questionnaires
• Treatment Outcome
• Ulcer (etiology, surgery)
• Urinary Bladder Diseases (etiology, surgery)
• Urologic Surgical Procedures (methods)