Electrosurgical Management of Hunner Ulcers in a Referral Center's Interstitial Cystitis Population

OBJECTIVE To characterize electrocautery (EC) as a valid treatment option in interstitial cystitis (IC) patients with Hunner ulcers (HUs). METHODS From 1997 to 2013, a single urologist's IC population was retrospectively reviewed to identify HU patients as well as their demographics, operative characteristics, and response to a 2-page questionnaire evaluating parameters of their experience with EC. Descriptive statistics, Pearson chi-square test, Student t test, and Pearson coefficient were used. RESULTS Two hundred fourteen EC procedures were performed in 76 patients (87% women; mean age, 66 +/- 1.67 years). Fifty-one patients (69%) who underwent multiple EC had mean initial bladder capacity of 438.62 +/- 27.90 mL and final bladder capacity of 422.40 +/- 30.10 mL. Mean number of EC procedures was 2.98 +/- 0.25 (range, 1-11). Mean time between sessions was 14.52 +/- 1.34 months (range, 1-121 months). Fifty-two patients (68%) completed our questionnaire, with 13.54 +/- 1.28 years of symptoms and 10.66 +/- 0.96 years since diagnosis. Ranking IC treatments, 37 patients (84%) reported EC most beneficial. On a 0-10 (none to worst possible) scale before and after EC, frequency improved from 9.04 +/- 1.30 to 3.65 +/- 2.75 (P < .001), urgency from 8.40 +/- 2.38 to 3.28 +/- 2.71 (P < .001), and pain from 8.62 +/- 2.36 to 2.68 +/- 2.55 (P < .001). Overall, 89.6% of patients noted some degree of symptom improvement after EC; 56.3% of patients had marked improvement. A total of 98% of patients would undergo EC again. CONCLUSION EC of HU is an effective and safe procedure with high patient satisfaction that does not diminish bladder capacity. (C) 2015 Elsevier Inc.