A Case of Interstitial Cystitis With Hunner Lesions Involving Bilateral Ureters

Q4 Medicine

IJU Case Reports Pub Date : 2025-04-29 DOI:10.1002/iju5.70010

Satoki Otsuka, Yoshiyuki Akiyama, Daichi Maeda, Aya Niimi, Kenichi Hashimoto, Jun Kamei, Satoru Taguchi, Yuta Yamada, Yusuke Sato, Daisuke Yamada, Tomonori Minagawa, Tetsuo Ushiku, Yukio Homma, Haruki Kume

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Abstract

Introduction

Interstitial cystitis with Hunner lesion (IC/HL) is an enigmatic, chronic inflammatory disease of the urinary bladder. Few documented cases have reported the IC/HL involving the upper urinary tract.

Case Presentation

A 51-year-old Japanese woman with IC/HL developed bilateral ureteral stenosis and associated hydronephrosis, resulting in increased serum creatinine concentrations. Cystography showed no evidence of bilateral vesicoureteral reflux or bladder deformity. Ureteroscopy showed severe ureteral stenosis due to mucosal hyperplasia at the mid/upper levels of both ureters, leading to the insertion of bilateral ureteral stents. Histological examination of the ureteral lesions showed similar chronic inflammatory changes to the bladder lesions, which were compatible with IC/HL. Bilateral ureteral stenosis persisted after a two-year corticosteroid treatment (prednisolone, 7.5 mg/day), while IC/HL symptoms have disappeared.

Conclusion

IC/HL could involve the upper ureters, and thus regular follow-up imaging of upper urinary tracts in patients with IC/HL is warranted.

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间质性膀胱炎伴双侧输尿管亨氏病变1例

间质性膀胱炎伴Hunner病变（IC/HL）是一种难以理解的膀胱慢性炎症性疾病。很少有文献报道IC/HL累及上尿路。一例51岁日本女性IC/HL患者发展为双侧输尿管狭窄并伴有肾积水，导致血清肌酐浓度升高。膀胱造影未显示双侧膀胱输尿管反流或膀胱畸形。输尿管镜检查显示双侧输尿管中/上段粘膜增生导致输尿管严重狭窄，导致双侧输尿管支架置入。输尿管病变组织学检查显示与膀胱病变相似的慢性炎性改变，符合IC/HL。双侧输尿管狭窄在两年皮质类固醇治疗（强的松龙，7.5 mg/天）后仍然存在，而IC/HL症状消失。结论IC/HL可累及上输尿管，IC/HL患者应定期进行上尿路影像学随访。

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