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Pain relief after triamcinolone infiltration in patients with bladder pain syndrome with Hunner’s ulcers

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Abstract

Introduction and hypothesis

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.

Conclusion

Triamcinolone injection for HU in patients with BPS is associated with significant pain reduction. However, most patients will require retreatment.

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Acknowledgments

We thank all study participants who shared their stories with us. We thank Helena Kruyer for the English correction of the manuscript.

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Correspondence to Laura Mateu.

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Written informed consent was obtained from the patient for publication of images in Urogynecology

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Additional information

Laura Mateu and Laura Izquierdo contributed equally to this work.

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Mateu, L., Izquierdo, L., Franco, A. et al. Pain relief after triamcinolone infiltration in patients with bladder pain syndrome with Hunner’s ulcers. Int Urogynecol J 28, 1027–1031 (2017). https://doi.org/10.1007/s00192-016-3213-3

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  • DOI: https://doi.org/10.1007/s00192-016-3213-3

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