Approximately 15% 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. Research released in 2014 (Van Der AA, et al. ) found that Hunner’s lesions patients had the polyoma virus in their urine. A new study released in September 2015 (Winter BJ, et al.) also found the virus in lesion patients and determined that the use of an older, rarely used therapy, Clorpactin, has an anti-DNA viral effect. More research is clearly needed but perhaps that would be a new use for a therapy that has largely been abandoned because of its caustic effects.
Hunner’s lesions must be diagnosed through cystoscopy, often utilizing hydrodistention. Unfortunately, many patients don’t realize that Hunner’s ulcers require separate bladder wall specific treatment.
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 ulcers 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.
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!
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.