Interstitial cystitis is bladder pain syndrome with Hunner's lesion

Abstract

Abbreviations & Acronyms Abstract:The contents and understanding of the term, interstitial cystitis, have undergone major changes during the past 100 years, moving from a chronic, true inflammatory bladder disorder to an extensive syndrome with lower urinary tract pain. Comments on this development are presented. From examples in the literature, some important features of classic interstitial cystitis are outlined. The more inclusive attitude of later decades has drawn desirable attention to the entire spectrum of disorders resulting in bladder pain. The wish to include all of them into one handy entity has unfortunately resulted in much scientific and clinical confusion, though. It is noted that originally interstitial cystitis represented the Hunner type of disease. Today, there is agreement that the classic type of interstitial cystitis with Hunner's lesions, bladder pain syndrome type 3C according to current terminology, stands out as a well-defined phenotype; it has to evaluated separately in clinical studies and practice, as treatment requirements differ importantly between this and other phenotypes

Is Urethral Pain Syndrome Really Part of Bladder Pain Syndrome?

“…Philip Syng Physick described an inflammatory condition of the bladder with an "ulcer" producing the same symptoms as a bladder stone in 1808 [12]. He expanded this concept to include chronic frequency, urgency, and pain syndrome, occurring in the absence of demonstrable etiology, which was called the 'tic douloureux of the bladder' in 1836 [12,13]. This may represent the first description of IC.…”

“…Fifty years later, Skene used the term IC to describe an inflammation that had "destroyed the mucous membrane partly or wholly and extended to the muscular parietes" in 1887 [14]. However, because of the distinctive clinical characterization of the syndrome, the physician who is always remembered and quoted is Guy Hunner [13]. Early in the 20th century, he described a symptom complex of bladder pain associated with distinguishing cystoscopic feature of mucosal lesions as the "elusive ulcer," which was later termed Hunner's ulcer.…”

“…Early in the 20th century, he described a symptom complex of bladder pain associated with distinguishing cystoscopic feature of mucosal lesions as the "elusive ulcer," which was later termed Hunner's ulcer. For several years, this finding was the hallmark of IC, and urologists would look for ulcers but failed to make the diagnosis in their absence [13].…”

Current approaches to the diagnostic of bladder pain syndrome

“…ст. в течение 1-2 минут, являются специфичными для СБМП и служат его диагностическим критерием [17][18][19]. На сегодняшний день принято следующее определение гуннеровского поражения: «Окрашен-ная в красный цвет зона слизистой с небольшими сосудами, сходящимися радиально к центрально-му рубцу, покрытому отложениями фибрина или сгустком, прикрепленным к этой зоне.…”

Reviewing Interstitial Cystitis Models and Treatments: A Focus on the Urothelium

“…In 1915 Guy Hunner characterized these lesions, describing the presence of red bleeding areas on the bladder wall, which since then have been known as Hunner's lesions (8). Thus, in the fifties of the twentieth century, Hand et al (1949) thoroughly studied the nature of the pathologic condition related to IC by using endoscopic and histologic techniques (9).…”