To improve the diagnosis of Hunner’s ulcer, the narrow band imaging cystoscopy (NBI) system was used. NBI delivers enhanced images of characteristic changes of lesions, capillary vessels, and the mucosal surface by controlling the wave length of light used, and it is used to improve the detection of bladder cancer.
This study looked into the use of the same technology to detect Hunner’s ulcer and the number of Hunner’s ulcers in patients with painful bladder syndrome. Cystoscopy and hydrodistension followed by NBI was performed in 19 patients. In addition, transuretheral fulguration assisted by NBI was added in this these patients. Treatment outcomes of transuretheral fulguration were evaluated by O’Leary and Sant Symptom and Problem Index score and visual analog score (VAS) of pain. Out of 19 patients, 17 patients were diagnosed as IC/PBS. Using white light, cystoscopy detected ulcers in 12 patients while using NBI detected Hunner’s ulcer in 13 patients. More interestingly, NBI technology enabled the urologist to see more ulcers than using regular white light cystoscopy. White light cystoscopy overlooked about 30% of Hunner’s lesions and NBI assisted transurethral fulguration.
Missing an ulcer, whether in a single case or multiple cases, can be a reason for treatment failure of ulcer type IC/PBS.
Presented by Mitsuru Kajiwara at the 29th World Congress of Endourology & SWL (WCE) - November 30 - December 3, 2011 - Kyoto International Conference Center - Kyoto, Japan
Reported for UroToday by Gamal Ghoniem, MD, FACS, Vice Chair and Professor of Urology, Department of Urology, University of California-Irvine Medical Center, Irvine, CA
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