To report the long-term clinical outcomes of transurethral resection of Hunner lesions with bladder hydrodistension in patients with Hunner lesion interstitial cystitis (HIC) at a tertiary referral center in Japan.
A retrospective chart review was conducted to evaluate the treatment outcomes of 104 patients with HIC who underwent initial endoscopic surgery, including transurethral resection of Hunner lesions (ablation was kept to a minimum) and concomitant bladder hydrodistension between 2017 and 2023. Clinical outcomes were evaluated and compared between each follow-up visit and baseline over 12 months using a 7-graded global response assessment (GRA), O'Leary and Sant's symptom and problem indices (OSSI/OSPI), an 11-point pain intensity numerical rating scale, quality of life (QOL) score, and frequency volume chart variables. Patients with GRA scores ≥ +2 (moderately/marked improved) and scores ≤ -1 (slightly/moderately/marked worse) were considered treatment responders and failures, respectively. Postoperative complications were also documented.
The mean duration to treatment failure was 30.9 ± 21.0 months. The overall response rates at 1, 3, 6, 9, and 12 months were 78.8%, 80.8%, 76.0%, 69.2%, and 57.7%, respectively. Compared with the baseline, the OSSI/OSPI, pain intensity, QOL score, urinary frequency, and functional bladder capacity improved significantly after 1 month and were maintained over 12 months. One patient required a second surgery for postoperative bleeding and another developed distal urethral stenosis 6 months post-surgery. No other patients developed any postoperative complications.
Transurethral resection of Hunner lesions combined with bladder hydrodistension offers long-term symptom relief without serious adverse events for treatment-naïve patients with HIC.
International journal of urology : official journal of the Japanese Urological Association. 2025 Sep 14 [Epub ahead of print]
Yoshiyuki Akiyama, Kenichi Hashimoto, Aya Niimi, Yukio Homma, Haruki Kume
Department of Urology, Shinshu University School of Medicine, Nagano, Japan., Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Department of Interstitial Cystitis Medicine, Kyorin University School of Medicine, Tokyo, Japan.