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Hunner's ulcers can only be accurately diagnosed via a cystoscopy, and at the same time can be treated with hydrodistention. The procedure is performed by a urologist either as an in office procedure or while the patient is under general anaesthesia as a day surgery.
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Diagnostic Criteria for IC, developed in 1987, required the presence of glomerulations or Hunner's Ulcers for diagnosis of IC and is still used today, to determine eligibility for some clinical trials. [2]
Guy LeRoy Hunner (1868–1957) was an American physician, surgeon, urologist and gynecologist at Johns Hopkins University School of Medicine in Baltimore, Maryland.. Hunner received his M.D. in 1897 as a member of the first graduating class of the Johns Hopkins University School of Medicine.
The most common symptoms of IC/BPS are suprapubic pain, [10] urinary frequency, painful sexual intercourse, [11] and waking up from sleep to urinate. [12]In general, symptoms may include painful urination described as a burning sensation in the urethra during urination, pelvic pain that is worsened with the consumption of certain foods or drinks, urinary urgency, and pressure in the bladder or ...
Rigid cystoscopy can be performed under the same conditions, but is generally carried out under general anesthesia, particularly in male subjects, due to the pain caused by the probe. The sizes of the sheath of the rigid cystoscope are 17 French gauge (5.7 mm diameter), 19 Fr gauge (6.3 mm diameter), and 22 Fr gauge (7.3 mm diameter).
Pressure ulcers can trigger other ailments, cause considerable suffering, and can be expensive to treat. Some complications include autonomic dysreflexia, bladder distension, bone infection, pyarthrosis, sepsis, amyloidosis, anemia, urethral fistula, gangrene and very rarely malignant transformation (Marjolin's ulcer – secondary carcinomas in chronic wounds).
Gene Clark (1944–1991, aged 46) had perforated ulcer and died on May 24, 1991. Doug Hepburn (1926–2000, aged 74) had a perforated ulcer and died on November 22, 2000. Philip Agee (1935–2008, aged 72) had a perforated ulcer and died on January 7, 2008. Barbara Bush (1925–2018, aged 92) was treated for a perforated ulcer in November 2008. [9]
A venous ulcer tends to occur on the medial side of the leg, typically around the medial malleolus in the 'gaiter area' whereas arterial ulcer tends to occur on lateral side of the leg and over bony prominences. A venous ulcer is typically shallow with irregular sloping edges whereas an arterial ulcer can be deep and has a 'punched out' appearance.