You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Interstitial Cystitis (MP07)1 Apr 2020MP07-05 DESCRIPTIVE ANALYSIS OF PATIENTS WITH HUNNER LESION TREATED WITH FULGURATION OR INTRALESIONAL TRIAMCINOLONE INJECTIONS IN ASSOCIATION WITH CYCLOSPORINE A Frederique Bouchard*, Raphaëlle Brière, Annie-Kim Gareau Labelle, and Le Mai Tu Frederique Bouchard*Frederique Bouchard* More articles by this author , Raphaëlle BrièreRaphaëlle Brière More articles by this author , Annie-Kim Gareau LabelleAnnie-Kim Gareau Labelle More articles by this author , and Le Mai TuLe Mai Tu More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000827.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Lesion fulguration or intralesional triamcinolone injections are the recommended efficient treatments for interstitial cystitis-bladder pain syndrome (IC-BPS) with Hunner lesions (IC-HL). However, repeated procedures due to symptom recurrence are frequent. Limited number of studies reported cyclosporine A (CyA) as an effective treatment for IC-HL, but adverse events (AE) are common thus making CyA a last-line option. Our objective was to assess the efficacy and safety of lesion fulguration or triamcinolone injections in association with oral CyA in patients with refractory IC-HL. We hypothesized that low-dose CyA could allow a sustained symptom alleviation therefore decreasing the need for repeated procedures and preventing occurrence of AE. METHODS: This was a retrospective observational study of 20 refractory IC-HL patients treated with daily 1.5 mg/kg of CyA following fulguration (n=16) or triamcinolone injection (n=4) between 2007 and 2019. Primary outcomes, assessed at the last follow-up, were pain severity (0 to 10 scale), flares and subjective improvement (assessed via Subjective Improvement Rate [SIR] and Patient Global Impression of Improvement [PGI-I]). Urinary frequency (UF), nocturia and CyA safety were evaluated as secondary outcomes. RESULTS: Median follow-up was 16.5 months. Among the 20 patients, the median pain score was 0/10 (8/10 pre-treatment) and only 2 patients still reported flares. Median SIR and PGI-I were 82.5% and 1/7 respectively, including 6 patients who considered themselves cured (SIR 100%). Post-treatment UF and nocturia also significantly improved (table 1). Following the procedure, 4 patients experienced symptoms relapse and required additional procedures while continuing CyA medication for adequate symptom relief. All other 16 patients maintained symptom alleviation at the last follow-up. No patient presented elevated blood pressure or clinically significant elevation in creatinine levels. CONCLUSIONS: CyA appears to be an efficient treatment following HL fulguration or triamcinolone injection by allowing sustained pain alleviation, great subjective improvement and a decrease in UF and nocturia. The low dose of 1.5 mg/kg seems to limit AE while still preventing symptom recurrence. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e97-e97 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Frederique Bouchard* More articles by this author Raphaëlle Brière More articles by this author Annie-Kim Gareau Labelle More articles by this author Le Mai Tu More articles by this author Expand All Advertisement PDF downloadLoading ...