Extent of Hunner lesions: The relationships with symptom severity and clinical parameters in Hunner type interstitial cystitis patients
Extent of Hunner lesions: The relationships with symptom severity and clinical parameters in Hunner type interstitial cystitis patients
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DOI：
10.1002/nau.23467
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发表时间：
2018-04-01
影响因子：
2
通讯作者：
Homma, Yukio
中科院分区：
文献类型：
--
作者：
Akiyama, Yoshiyuki;Niimi, Aya;Homma, Yukio
目的：目的：探讨Hunner型间质性膀胱炎（HIC）中Hunner病变的临床意义。方法：回顾性分析94例首次行膀胱水扩张（病变电灼）治疗的HIC患者的临床资料。在手术中，根据整个膀胱腔表面的相对受累程度对每个病变的程度进行分类;我们定义了四个受累等级：<10%，10- 24%，25- 49%和>= 50%;以及两个严重程度等级：< 25%（局灶性）和>= 25%（广泛性）。我们研究了病变程度与所有人口统计学特征、症状评分、排尿症状和膀胱容量之间的关系。预测需要重复水扩张的因素也explored.Results：症状的严重程度恶化的病变范围上升。那些有广泛病变的人在O 'Leary和Sant症状上得分更高（P = 0.004）和问题指数量表疼痛视觉模拟量表评分（P < 0.001）（P = 0.011），国际前列腺症状评分量表（P = 0.012），生活质量指数（P = 0.020）;白天排尿频率更高（P = 0.040）、更多的排尿量（P = 0.041）和更小的膀胱容量（P = 0.007）。没有症状或临床参数预测需要重复水扩张。结论：Hunner病变的程度与症状严重程度和膀胱容量相关，但与其他临床参数无关，包括HIC患者需要重复水扩张。
Aims: To assess the clinical impact of Hunner lesions in patients with Hunner type interstitial cystitis (HIC).Methods: The clinical records of 94 HIC patients who underwent their first hydrodistension (with lesion fulguration) were retrospectively reviewed. At surgery, the extent of each lesion was classified in terms of the relative involvement for the whole- bladder luminal surface; we defined four grades of involvement: < 10%, 10- 24%, 25- 49%, and >= 50%; and two grades of severity: < 25% (focal) and >= 25% (extensive). We examined the relationships between the extent of the lesions and all demographic characteristics, symptom scores, voiding symptoms, and bladder capacity. Factors predictive of the need for repeat hydrodistension were also explored.Results: Symptom severity worsened as the lesional extent rose. Those with extensive lesions scored higher on the O'Leary and Sant Symptom (P = 0.004) and Problem Index scales (P < 0.001), the pain visual analog scale (P = 0.011), the International Prostate Symptom Score scale (P = 0.012), and a quality- of- life index (P = 0.020); and exhibited greater daytime urinary frequency (P = 0.040), more nocturia (P = 0.041), and a smaller bladder capacity (P = 0.007) than the focal group. No symptomatic or clinical parameters predicted the need for repeat hydrodistension.Conclusions: The extent of Hunner lesions was associated with both symptom severity and bladder capacity but not with other clinical parameters, including the need for repeat hydrodistension, in patients with HIC.