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Extent of Hunner lesions: The relationships with symptom severity and clinical parameters in Hunner type interstitial cystitis patients
Author(s) -
Akiyama Yoshiyuki,
Niimi Aya,
Nomiya Akira,
Yamada Yukio,
Nakagawa Tohru,
Fujimura Tetsuya,
Fukuhara Hiroshi,
Kume Haruki,
Igawa Yasuhiko,
Homma Yukio
Publication year - 2018
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.23467
Subject(s) - medicine , interstitial cystitis , nocturia , severity of illness , lesion , visual analogue scale , international prostate symptom score , fulguration , urology , lower urinary tract symptoms , urinary system , prostate , surgery , cancer
Aims To assess the clinical impact of Hunner lesions in patients with Hunner type interstitial cystitis (HIC). Methods 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. Results 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. Conclusions 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.