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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 ...
It is common for those recovering from surgery to experience gastrointestinal problems (29% of those who underwent radical cystectomy), infections (25%), and other issues with the surgical wound (15%). [36] Around 25% of those who undergo the surgery end up readmitted to the hospital within 30 days; up to 2% die within 30 days of the surgery. [36]
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).
Classically, there is a solitary ulcer. But only 20% of patients have a single ulcer whereas in other cases there may be multiple lesions. [6] The size of the ulcers is usually 0.5–4 cm. [5] The lesion is most often located on the anterior (front) or lateral (side) rectal wall, centered on a rectal fold, [1] usually 10 cm from the anal verge. [8]
The ulcer is known initially as a peptic ulcer before the ulcer burns through the full thickness of the stomach or duodenal wall. A diagnosis is made by taking an erect abdominal/chest X-ray (seeking air under the diaphragm). This is in fact one of the very few occasions in modern times where surgery is undertaken to treat an ulcer. [3]