Frederick Van Moh1, Joel Vetter1, H Henry Lai1,2. 1. Division of Urologic Surgery, Department of Surgery, St. Louis, Missouri. 2. Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri.
Abstract
AIMS: To compare severity and characteristics of urologic pain, other urinary symptoms, sexual pain, psychosocial health, and the distribution and intensity of non-urologic pain between men and women with and without Hunner lesions. METHODS: All cystoscopies were performed and documented by the same clinician to ensure uniform recognition of Hunner lesions. Intensity of urologic and sexual pain, nocturia, frequency, urgency, and bladder hypersensitivity features were assessed using validated questionnaires and numeric rating scales. The distribution and intensity of non-urologic pain was assessed using self-reported history, a body map diagram, and numeric rating scales. Somatic symptom burden, depression, and anxiety were compared. RESULTS: Among the 150 participants, 27% (n = 41) had Hunner lesions (36% of men, 25% of women). Participants with Hunner lesions were significantly older (median age 58 vs 41, P < 0.001). They reported less intense urologic pain (5 vs 7, P = 0.024) and more nocturia (ICSI nocturia symptom score: 4 vs 3, P = 0.007). They also were less likely to have a history of irritable bowel syndrome (15% vs 36%, P = 0.013) and anxiety attacks (22% vs 44%, P = 0.013). Close to half of Hunner IC patients had non-urologic pain outside the pelvis. There were no differences in bladder hypersensitivity features (eg, painful bladder filling) between the two groups. CONCLUSIONS: Hunner lesions can be identified in both men and women. There are significant overlaps in terms of their urologic and non-urologic presentation. Further investigation is needed on phenotypic and biological distinction between IC/BPS with and without Hunner lesions.
AIMS: To compare severity and characteristics of urologic pain, other urinary symptoms, sexual pain, psychosocial health, and the distribution and intensity of non-urologic pain between men and women with and without Hunner lesions. METHODS: All cystoscopies were performed and documented by the same clinician to ensure uniform recognition of Hunner lesions. Intensity of urologic and sexual pain, nocturia, frequency, urgency, and bladder hypersensitivity features were assessed using validated questionnaires and numeric rating scales. The distribution and intensity of non-urologic pain was assessed using self-reported history, a body map diagram, and numeric rating scales. Somatic symptom burden, depression, and anxiety were compared. RESULTS: Among the 150 participants, 27% (n = 41) had Hunner lesions (36% of men, 25% of women). Participants with Hunner lesions were significantly older (median age 58 vs 41, P < 0.001). They reported less intense urologic pain (5 vs 7, P = 0.024) and more nocturia (ICSI nocturia symptom score: 4 vs 3, P = 0.007). They also were less likely to have a history of irritable bowel syndrome (15% vs 36%, P = 0.013) and anxiety attacks (22% vs 44%, P = 0.013). Close to half of Hunner IC patients had non-urologic pain outside the pelvis. There were no differences in bladder hypersensitivity features (eg, painful bladder filling) between the two groups. CONCLUSIONS:Hunner lesions can be identified in both men and women. There are significant overlaps in terms of their urologic and non-urologic presentation. Further investigation is needed on phenotypic and biological distinction between IC/BPS with and without Hunner lesions.
Authors: H Henry Lai; Craig Newcomb; Steve Harte; Dina Appleby; A Lenore Ackerman; Jennifer T Anger; J Curtis Nickel; Priyanka Gupta; Larissa V Rodriguez; J Richard Landis; J Quentin Clemens Journal: Neurourol Urodyn Date: 2021-02-19 Impact factor: 2.696