Approximately 5% of IC patients have profound, extremely painful areas of inflammation in the bladder wall known as Hunner’s Lesions (formerly Hunner’s Ulcers). These larger, bleeding wounds in the bladder represent the most severe form of interstitial cystitis and bladder pain syndrome. Some researchers believe that Hunner’s lesions represent a completely different medical condition than typical IC.
Hunner’s lesions must be diagnosed through cystoscopy, often utilizing hydrodistention. Unfortunately, many patients don’t realize that Hunner’s lesions require very specific treatment. Step Three of the AUA Treatment Guidelines outline current treatments for Hunner’s lesions including: fulguration, laser therapy and/or the injection of triamcinolone into the center of the ulcer.
Patients struggling with Hunner lesion in the USA & Canada may be able to participate in a new clinical trial. LiRIS is a new medical device that delivers lidocaine into the bladder for a two week period. In their first study for pain, the researchers found that the ulcers also responded favorably to treatment. A new clinical trial testing the effectiveness of LiRIS in the treatment of Hunner’s Ulcers was launched in Fall 2013. Read more about the trial!
PATIENT TIP – If you are going to have a hydrodistention, it’s important to talk with your doctor about how they will be treating any lesions they find. To NOT treat an ulcer is a lost opportunity that could result in long periods of pain and discomfort and require additional hydrodistention.
Watch a Hunner’s Lesion Video
Dr. Tomohiro Ueda (Japan) and the AUA released the video below, showing what a Hunner’s lesion looks like and how it responds during a hydrodistention procedure.
Your Experience With Ulcers
Do you have Ulcers? How were they treated? Did treatment help?? Have they recurred?? Please share your story below or on our Facebook page.
I have had a hydrodistention. My doctor cauterized my ulcers almost two years ago. I have not felt pain as bad as I had before the treatment. I was pregnant with my youngest daughter when I was diagnosed. The doctors kept telling me I had recurring urinary tract infections and it was sometimes normal during pregnancy. This was my third child and I had never felt pain as intensely with my other two pregnancies. I could not walk because the pain was so unbearable. I still have flares of pain every few months but it’s not as bad as before. I am now able to work a full time job and take care of my children.
I have had many hydrodistentions over the last 30 years and only during the last one was a Hunner’s Lesion found. It was fulgurated and I was extremely uncomfortable for several days after but then I had bladder installations with a cocktail including lidocaine once a week for 7 weeks and have been fairly comfortable since. That has been about a year ago.