title: Electrosurgical management of Hunner ulcers in a referral center's interstitial cystitis population.
abstract: OBJECTIVE
  To characterize electrocautery (EC) as a valid treatment option in interstitial cystitis (IC) patients with Hunner ulcers (HUs).
  
  
  METHODS
  From 1997 to 2013, a single urologist's IC population was retrospectively reviewed to identify HU patients as well as their demographics, operative characteristics, and response to a 2-page questionnaire evaluating parameters of their experience with EC. Descriptive statistics, Pearson chi-square test, Student t test, and Pearson coefficient were used.
  
  
  RESULTS
  Two hundred fourteen EC procedures were performed in 76 patients (87% women; mean age, 66 ± 1.67 years). Fifty-one patients (69%) who underwent multiple EC had mean initial bladder capacity of 438.62 ± 27.90 mL and final bladder capacity of 422.40 ± 30.10 mL. Mean number of EC procedures was 2.98 ± 0.25 (range, 1-11). Mean time between sessions was 14.52 ± 1.34 months (range, 1-121 months). Fifty-two patients (68%) completed our questionnaire, with 13.54 ± 1.28 years of symptoms and 10.66 ± 0.96 years since diagnosis. Ranking IC treatments, 37 patients (84%) reported EC most beneficial. On a 0-10 (none to worst possible) scale before and after EC, frequency improved from 9.04 ± 1.30 to 3.65 ± 2.75 (P <.001), urgency from 8.40 ± 2.38 to 3.28 ± 2.71 (P <.001), and pain from 8.62 ± 2.36 to 2.68 ± 2.55 (P <.001). Overall, 89.6% of patients noted some degree of symptom improvement after EC; 56.3% of patients had marked improvement. A total of 98% of patients would undergo EC again.
  
  
  CONCLUSIONS
  EC of HU is an effective and safe procedure with high patient satisfaction that does not diminish bladder capacity.
authors.affiliation: Department of Urology, Beaumont Health System, Royal Oak, MI. Electronic address: Avi.chennamsetty@gmail.com.
authors.forename: Avinash
authors.initials: A
authors.lastname: Chennamsetty
authors.affiliation: Department of Urology, Beaumont Health System, Royal Oak, MI.
authors.forename: Iyad
authors.initials: I
authors.lastname: Khourdaji
authors.affiliation: Oakland University William Beaumont School of Medicine, Rochester, MI.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Goike
authors.affiliation: Department of Urology, Beaumont Health System, Royal Oak, MI.
authors.forename: Kim A
authors.initials: KA
authors.lastname: Killinger
authors.affiliation: Division of Urology, University of Colorado Health, Fort Collins, CO.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Girdler
authors.affiliation: Department of Urology, Beaumont Health System, Royal Oak, MI; Oakland University William Beaumont School of Medicine, Rochester, MI.
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Peters
mesh_terms: D000368:Aged; D018856:Cystitis, Interstitial / Q000150:complications*; D004564:Electrocoagulation; D005260:Female; D006801:Humans; D008297:Male; D012017:Referral and Consultation; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014456:Ulcer / Q000209:etiology* / Q000601:surgery*; D001745:Urinary Bladder Diseases / Q000209:etiology / Q000601:surgery; D013520:Urologic Surgical Procedures / Q000379:methods