Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St Louis, Missouri, USA.
Department of Anesthesiology, Washington University School of Medicine, St Louis, Missouri, USA.
Neurourol Urodyn. 2020 Nov;39(8):2394-2400. doi: 10.1002/nau.24500. Epub 2020 Sep 9.
To assist clinicians in proper visual diagnosis of Hunner lesions by providing an atlas of representative images of the variability in Hunner lesion appearance.
Available cystoscopic images of Hunner lesions were reviewed from patients with interstitial cystitis or bladder pain syndrome (IC/BPS) treated by a single clinician between 2011 and 2020. For most patients, initial cystoscopy was performed in the office under local anesthesia. Images were categorized by variations in appearance. Data including Hunner lesion descriptions and patient demographics were retrospectively collected from the medical record. Only patients who had images available, received triamcinolone injection and/or fulguration of Hunner lesions, and reported improvement of their symptoms following treatment were included in the atlas.
Thirty-one IC/BPS patients with Hunner lesions had cystoscopic images available for review. We created an atlas of representative images. Variations in appearance include classic lesions with or without a central coagulum, inflamed lesions, non-inflamed lesions, groupings of lesions, and lesions with a red waterfall bleeding appearance.
There is variation in cystoscopic appearance of Hunner lesions. Most Hunner lesions can be identified during office visits using flexible cystoscopy and local anesthesia without hydrodistention or general anesthesia. Proper visual diagnosis of Hunner lesions is of upmost importance as these patients with IC/BPS respond greatly to endoscopic intervention. This atlas will serve as a reference for clinicians and researchers, so they are able to better identify and manage these patients.
通过提供 Hunner 病变表现多样性的代表性图像图谱，帮助临床医生正确进行视觉诊断。
回顾性分析了 2011 年至 2020 年间，由一名医生治疗的间质性膀胱炎或膀胱疼痛综合征（IC/BPS）患者的膀胱镜检查中 Hunner 病变的可用图像。对于大多数患者，初始膀胱镜检查在局麻下于诊室进行。根据外观的变化对图像进行分类。从病历中收集包括 Hunner 病变描述和患者人口统计学数据在内的数据。仅纳入有图像、接受曲安奈德注射和/或 Hunner 病变烧灼、并报告治疗后症状改善的患者进入图谱。
31 例 IC/BPS 患者有 Hunner 病变的膀胱镜检查图像可供回顾。我们创建了一个具有代表性图像的图谱。外观的变化包括有或无中央凝块的典型病变、炎症病变、非炎症病变、病变群集和红色瀑布状出血外观的病变。
Hunner 病变的膀胱镜下表现存在差异。大多数 Hunner 病变可在局麻下使用软式膀胱镜检查进行识别，无需水扩张或全身麻醉。正确的 Hunner 病变视觉诊断至关重要，因为这些 IC/BPS 患者对内镜干预反应良好。该图谱将为临床医生和研究人员提供参考，以便他们能够更好地识别和管理这些患者。
