Introduction: This study aims to evaluate the effectiveness of kenalog injection into Hunner's lesions. Materials and Methods: All patients had cystoscopy and bladder hydrodistention with corticosteroid injection into Hunner's lesions over a 2.5-year period. Data include patient characteristics and pre- and post-operative validated questionnaires. Spearman Correlation and Wilcoxon t-tests were used for analysis. Results: One hundred patients were reviewed retrospectively. There was a 1.1 point decrease in pain at 12 weeks post-operation (p = 0.435). Urinary frequency decreased from a mean of 11.7 to 9.1 daily episodes (p = 0.05), and nocturia from a mean of 3 to 1.6 nightly episodes (p = 0.008). Conclusion: The use of a corticosteroid may be beneficial to symptom control and improvement in the quality of life of interstitial cystitis/painful bladder syndrome patients. Patients had improved frequency and nocturia 12 weeks post injection.
Aims: To identify risk factors for urinary retention following AdVance™ Sling placement using preoperative urodynamic studies to evaluate bladder contractility. Methods: A multi-institutional retrospective review of patients who underwent an AdVance Sling for post-prostatectomy stress urinary incontinence from 2007 to 2019 was performed. Acute urinary retention (AUR) was defined as the complete inability to void or elevated post-void residual (PVR) leading to catheter placement or the initiation of intermittent catheterization at the first void trial postoperatively. Bladder contractility was evaluated based on preoperative urodynamics. Results: Of the 391 patients in this study, 55 (14.1%) experienced AUR, and 6 patients (1.5%) had chronic urinary retention with a median follow-up of 18.1 months. In total, 303 patients (77.5%) underwent preoperative urodynamics, and there was no significant difference between average PdetQmax (26.4 vs. 27.4 cmH 2 O), Qmax (16.6 vs. 16.2 ml/s), PVR (19.9 vs. 28.1 ml), bladder contractility index (108 vs. 103) for patients with or without AUR following AdVance Sling. Impaired bladder contractility preoperatively was not predictive of AUR. Time to postoperative urethral catheter removal was predictive of AUR (odds ratio, 0.83; 95% confidence interval, 0.73-0.94; p = .003). Conclusions: Chronic urinary retention after AdVance Sling placement is uncommon and acute retention is generally self-limiting. No demographic or urodynamic factors were predictive of AUR. Patients who developed AUR were more likely to have their void trials within 2 days following AdVance Sling placement versus longer initial catheterization periods, suggesting that a longer duration of postoperative catheterization may reduce the occurrence of AUR.
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