title: Pain relief after triamcinolone infiltration in patients with bladder pain syndrome with Hunner's ulcers.
abstract: OBJECTIVE
  Bladder pain syndrome (BPS) is a chronic condition with severe implications in the patient's quality of life with no definitive treatment. Our objective was to assess pain relief after triamcinolone injection in patients with BPS with Hunner's ulcers (HU).
  
  
  METHODS
  Retrospective study of 20 consecutive patients with BPS treated at the Hospital Clinic of Barcelona with triamcinolone injection with flexible cystoscope between 2015 and 2016. Pain was assessed according to the visual analog scale (VAS) (0-10) before and after treatment. Outcomes were compared using Student's t test for paired samples.
  
  
  RESULTS
  Twenty-seven procedures were performed in 20 patients, who were followed up for a median of 7 months (range 1-15). Median age was 75 years (52-86), and median time from diagnosis to treatment was 4.5 years (1-7). Fifteen (75 %) patients had received treatment with corticoid injection for BPS before entering the study. Pre- and postreatment VAS was 8 and 2.5 (p < 0.001), respectively. Pre -and postreatment VAS in those with muscular pain was 8 and 5 (p = 0.012), respectively and in those without muscular pain was 8 and 2 (p < 0.001), respectively. Three (15 %) patients required retreatment due to nonresponse and 5 (25 %) patients for pain recurrence after 4 months (3.5-8). Four of them (50 %) were performed with triamcinolone injection again. Seven of ten patients (70 %) followed for ≥8 months required at least one retreatment.
  
  
  CONCLUSIONS
  Triamcinolone injection for HU in patients with BPS is associated with significant pain reduction. However, most patients will require retreatment.
authors.affiliation: Department and Laboratory of Urology of Hospital Clinic, Barcelona, Spain. lmateuarrom@hotmail.com.|Department of Urology of Hospital Plató, Barcelona, Spain. lmateuarrom@hotmail.com.
authors.forename: Laura
authors.initials: L
authors.lastname: Mateu
authors.affiliation: Department and Laboratory of Urology of Hospital Clinic, Barcelona, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Izquierdo
authors.affiliation: Department and Laboratory of Urology of Hospital Clinic, Barcelona, Spain.
authors.forename: Agustín
authors.initials: A
authors.lastname: Franco
authors.affiliation: Department and Laboratory of Urology of Hospital Clinic, Barcelona, Spain.
authors.forename: Meritxell
authors.initials: M
authors.lastname: Costa
authors.affiliation: Department of Surgery, University of Melbourne, Austin Hospital, Melbourne, Australia.
authors.forename: Nathan
authors.initials: N
authors.lastname: Lawrentschuk
authors.affiliation: Department and Laboratory of Urology of Hospital Clinic, Barcelona, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Alcaraz
mesh_terms: D000283:Administration, Intravesical; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014221:Triamcinolone / Q000008:administration & dosage*; D014456:Ulcer / Q000188:drug therapy*; D001745:Urinary Bladder Diseases / Q000188:drug therapy*
chemical_list: D000893:Anti-Inflammatory Agents; D014221:Triamcinolone
keywords: Bladder pain syndrome; Hunner ulcer; Triamcinolone