Payne Ryan A, O'Connor R Corey, Kressin Margarita, Guralnick Michael L
Medical College of Wisconsin, Milwaukee, WI.
Can Urol Assoc J. 2009 Dec;3(6):473-7. doi: 10.5489/cuaj.1178.
We report our experience with endoscopic ablation of Hunner's lesions in women with interstitial cystitis (IC).
A chart review was performed on 14 patients with IC symptoms who were identified to have bladder lesions and underwent 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 improvement in pain was used as the main outcome measure.
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.
Endoscopic ablation of Hunner's lesions improves symptoms in IC patients. Recurrence of symptoms should prompt repeat cystoscopy to identify recurrent lesions, as repeat ablation offers symptomatic improvement.
我们报告了对间质性膀胱炎（IC）女性患者进行Hunner病变内镜下消融的经验。
对14例有IC症状且被确定有膀胱病变并接受内镜下消融的患者进行病历回顾。Hunner病变被确定为膀胱镜触碰时会再现患者疼痛的红斑区域。审查病理报告，并将疼痛改善作为主要结局指标。
14例患者中，12例有超过50%的症状改善，8例患者报告症状完全改善。平均改善率为76%。所有症状改善的患者，活检标本均显示为炎症性膀胱炎，常伴有上皮剥脱。4例患者症状复发，但再次消融后均有改善。
Hunner病变的内镜下消融可改善IC患者的症状。症状复发应促使再次进行膀胱镜检查以识别复发病变，因为再次消融可改善症状。
