Gender Disparities in Procedural Management of Hunner Lesion Interstitial Cystitis

Area of Science:

• Urology
• Gynecology
• Pelvic Health

Background:

• Interstitial cystitis/bladder pain syndrome (IC/BPS) affects millions with chronic pelvic pain and urinary symptoms.
• Hunner-type IC (HIC), a severe subtype, presents distinct pathology and higher symptom burden.
• Existing research on IC/BPS shows sex-based differences, but HIC-specific data is limited.

Purpose of the Study:

• To investigate sex-based differences in the clinical presentation of HIC.
• To analyze sex-based variations in the management and treatment outcomes for HIC patients.
• To identify predictors of disease progression, including repeat fulguration and cystectomy, in HIC.

Main Methods:

• Retrospective analysis of 114 HIC patients managed between 2011 and 2024.
• Assessment of sex differences in diagnostic timelines, symptom reporting, and quality of life.
• Cox proportional hazards models used to determine predictors of repeat fulguration and cystectomy.

Main Results:

• Females reported higher rates of anxiety, recurrent UTIs, and pelvic pain, with longer diagnostic delays.
• Males experienced nocturia more frequently; male sex predicted repeat fulguration.
• Cystectomy progression was associated with clinical severity markers like multidrug-resistant UTIs and hematuria, irrespective of sex.

Conclusions:

• Significant sex-based differences exist in HIC presentation and management, despite similar disease severity.
• Female patients exhibit a higher symptom burden, while male sex is a predictor for repeat fulguration.
• Findings underscore the necessity for sex-stratified diagnostic and treatment strategies for HIC.