Kenalog Injection into Hunner’s Lesions as a Treatment for Interstitial Cystitis/Bladder Pain Syndrome

Abstract

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.

Clinical efficacy of submucosal injection of triamcinolone acetonide in the treatment of type II/III interstitial cystitis/bladder pain syndrome

“…The current study shows that the duration of the treatment effect of simple bladder hydrodistention for IC/ BPS is generally less than 6 months, and the duration of the treatment effect of submucosal injection of TA for IC/BPS is not clear. The longest follow-up time in the current study was only 3 months [5]. We performed a follow-up of all patients for at least 1 year, and 43% of the patients had a one-year remission period in terms of symptom control after this treatment.…”

“…Cox and other researchers pioneered the submucosal TA injection method for the treatment of refractory Hunner's lesion-subtype IC/BPS patients and reported satisfactory results 4 . A preliminary study by Rittenberg et al on IC/ BPS patients with Hunner's lesions and bladder mucosal fissures also showed that TA contributes to symptom control and improves the quality of life of IC/BPS patients [5].…”

“…Cox and other researchers have reported treating female patients with type III IC/BPS with submucosal TA injection [4]. Whether this treatment is effective for male patients remains unclear, and no studies have reported treating type II IC/BPS using the same method [4,5]. This study is the first to include male patients and type II IC/BPS patients.…”

Retrospective Review of 5-Year Experience with Intravesical Injections of Bupivacaine, Triamcinalone and Gentamicin for Interstitial Cystitis/ Bladder Pain Syndrome

“…The use of submucosal injection of triamcinolone (TA) was first reported by Cox et al in patients of refractory Hunner's lesion sub-type of IC/BPS [10]. Rittenberg and Jiang have also reported good results with the use of TA intravesical injections [11,12].…”

The surgical options for Hunner’s lesions: an update

“…There was no significant decrease in pain scores at 12 weeks post injection, however, a significant reduction in frequency and nocturia was reported. 28 At the 2017 AUA annual scientific meeting in Boston, a group from Barcelona published their results of the intravesical injection of triamcinolone in 20 patients with BPS and Hunner's lesions; the median follow-up was 7 months, and most patients followed up required re-treatment within 8 months. Despite this, patients did report a significant reduction in pain.…”