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MP29-05: Pain relief after triamcinolone infiltration in patients with bladder pain syndrome with Hunner's Ulcers

Saturday, May 13
9:30 AM - 11:30 AM
Location: BCEC: Room 151

Presentation Authors: Laura Mateu Arrom*, Laura Izquierdo, Agustín Franco, Barcelona, Spain, Nathan Lawrentschuk, Melbourne, Australia, Lluís Peri, Meritxell Costa, Antonio Alcaraz, Barcelona, Spain

Introduction: Bladder pain syndrome (BPS) is a chronic condition with severe implications in quality of life and no definitive treatment. Our aim was to assess pain relief after triamcinolone infiltration (TI) in patients with BPS with Hunner&[prime]s Ulcers (HU).

Methods: Retrospective study of those consecutive patients with BPS and HU treated with TI at the Hospital Clinic of Barcelona between 2015 - 2016. TI was offered as a sole treatment when there was no evidence of other pelvic pathologies or infection and more conservative treatments had failed.

We collected data about previous treatments for BPS and presence of urinary symptoms. A pelvic floor muscle palpation was performed to detect myofascial pain.

TIs were performed with a 16Ch flexible cystoscope as an outpatient procedure. Triamcinolone doses were 40mg in 1ml, diluted with 9mls of 5% sugar solution. Every HU was treated with 3-5 injections of 1ml of the dilution, depending on the HU extension.

Pain was assessed according to a Visual Analogue Scale (VAS) (0: no pain; 10: very severe pain) before and after treatment. We considered response to treatment a VAS improvement ≥ 4. Outcomes were compared with T-Student test for paired samples. Ethical approval was obtained from Hospital Clinic Ethical Board.


Results: Twenty-seven procedures were performed in 20 patients, 19 women and 1 man, followed-up for a median of 7 months (range 1-15). Median age was 75 years (52-86).

Table 1 shows patients&[prime] characteristics.

Table 2 shows response to TI and comparison of VAS before and after TI.

Three (15%) patients required retreatment due to non response and 5 (25%) patients for pain recurrence at a median of 4 months (3.5-8). Seven out of 10 patients who were followed up for 8 months or more required at least one retreatment.

Conclusions: Triamcinolone infiltration in HU in patients with BPS is associated with significant pain reduction. However, most patients will require retreatment during follow-up

Source Of Funding: None

Laura Mateu Arrom

Hospital Plató - Hospital Clínic Barcelona

Personal information
Date of birth: 23rd October 1986
Nationality: Spanish

Academic achievements
- Degree in Medicine, University of Barcelona, Barcelona, Spain (2004-2010)
- Resident Intern examination (MIR examination), 29th January 2011
- Urology Resident (MIR programme), Hospital Clínic Barcelona, Barcelona, Spain (2011 -2016)
- Urology Consultant, Hospital Plató, Barcelona, Spain (2016 - present)

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MP29-05: Pain relief after triamcinolone infiltration in patients with bladder pain syndrome with Hunner's Ulcers



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