If you struggle with Hunner’s lesions (aka Hunne’s ulcers), the odds are that you’ve tried a variety of bladder treatments with little effect. Why is Elmiron and/or DMSO ineffective for Hunner’s lesions? Because they don’t treat the lesion directly. The American Urology Association recommends lesion directed therapy: fulguration, laser therapy and/or triamcinolone injection into the lesion. The challenge with the first two (and any heat treatment) is that it can leave scarring which can then reduce the ability of the bladder to expand (i.e. bladder capacity). In contrast, simply injecting the lesion with a simple steroid solution is just as effective but far less traumatic on the patient and the bladder.
Researchers at the Hofstra Northwell School of Medicine (New York) studied the effectiveness of low dose triamcinolone injection for HL treatment. A total of 36 patients received this treatment at their facility between 2001 and 2015. 78% were female and 22% were male. Of these, 72% received just one set of infections. 22% received 2 sets of injections and 5.5% received 3 or more injections with triamcinolone. The average time between injections was just less than a year.
Their reduction in pain was remarkable. Prior to treatment, their pain scores were 8.3 using the Likert pain scale. One month after treatment their pain scores reduced to 3.8. Nighttime frequency reduced from 7.5 to 5.1 after treatment. Researchers conclude that triamcinolone treatment of Hunner’s lesions is effective and durable, with low morbidity. It can be performed on an outpatient basis.
Of course, we continue to await the results of the latest LiRIS study for the treatment of Hunner’s lesions. In previous studies, the LiRIS medical device was found to reduce the size, quantity and/or completely resolve lesions with a simple two week treatment. More on that to come!
- Funaro MG, et al. Endoscopic Injection of Low Dose Triamcinolone: a Simple, Minimally Invasive and Effective Therapy for Interstitial Cystitis with Hunner Lesions. Urology 2018 May 18
- Guttman Krater C. Device efficacious for treating IC with Hunner’s lesions. Urology Times. October 1, 2016