Page 8 - CUA 2020_Trauma and Reconstruction

2020 CUA Abstracts

MP-2.11 treatment was pentosan polysulfate (54.2%), and 28% of patients were
Patient perspectives on cannabinoids for interstitial cystitis/ using opioids for BPS. The median age at first triamcinolone injection
bladder pain syndrome was 69 (IQR 56–74), and the median number of injections/patient was
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Kate Anderson , Danielle Jenkins , Mary E. Lynch , Ashley R. Cox 1 three (IQR 2–6). Median time between injections was 6.5 months (IQR
1 Urology, Dalhousie University, Halifax, NS, Canada; Urology, Queen’s 5–10). With a mean followup time of 3.3 years (4.5–99.6 months), all
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University, Kingston, ON, Canada; Anesthesia, Pain Management & patients had improvement in pain symptoms with one or more injec-
Perioperative Medicine, Dalhousie University, Halifax, NS, Canada tions. A durable effect of at least two months was seen after 85.2% of
Introduction: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic injections. Two patients had complete resolution of lesions. There was a
condition often causing a significant impact on quality of life. We sought significant decrease in the number of pain treatments required follow-
to: determine if patients with IC/BPS use cannabis products for symptoms of ing triamcinolone injections (2.68 vs. 1.04; p=0.0015). Fifty-two percent
IC/BPS, elicit perceptions of patients with IC/BPS regarding use of cannabis managed with triamcinolone injections alone, with no other pain treat-
products, and determine if higher Pain and Urgency/Frequency Symptom ments. Of the seven patients using opioids, four discontinued opioids,
Scale (PUF) scores correlate to use of cannabinoid products. while one decreased to as-needed use. One patient on warfarin had gross
Methods: We conducted a cross-sectional survey study of IC/BPS patients hematuria following the procedure and required overnight admission; no
at our center. Patients were asked to complete two anonymous surveys: 1) other complications were found.
a demographics and perceptions of cannabis survey; and 2) PUF symptom Conclusions: Injection of triamcinolone into Hunner’s lesions as a treat-
scale. Descriptive statistics were used to characterize the survey responses. ment for BPS is safe and effective and decreases the need for other pain
Results: Of the 97 patients who participated, 80% completed both sur- treatments.
veys. Average age was 49±16.5 years; 95% of respondents were female.
Median duration of IC/BPS symptoms was nine years. Reported cannabis MP-2.13
use was 58% (56/97) and 82% (37/45) found it to be at least slightly Treating the lesion in Hunner’s lesion interstitial cystitis/bladder
effective for symptom control. Cannabis use resulted in decrease or dis- pain syndrome (HL-IC/BPS): A call to arms
continuation of their other IC/BPS medications for 17% of respondents. R. Christopher Doiron , Kerri-Lynn Kelly , Brad Dean , J. Curtis Nickel 1
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Most patients reported no negative side effects from cannabis use (60%). 1 Urology, Queen’s University, Kingston, ON, Canada
Moderate to severe side effects were reported by 12.5% of patients. The Introduction: Hunner’s lesion interstitial cystitis/bladder pain syndrome
three most common modalities used were: smoked, oils, edibles. The (HL-IC/BPS), a distinct subtype of IC/BPS only identified by cystoscopy,
mean total PUF score was 20.4±7.4. There was no correlation found can be treated with transurethral resection, fulguration, and/or injection.
between cannabis use and total PUF score (r=0.041, n=78, p=0.724). We queried our large database to examine patterns and clinical outcomes
We found no statistically significant difference in severity of PUF total in directed lesion treatment in HL-IC/BPS.
score for patients who had used cannabis within the last six months and Methods: HL-IC/BPS subjects were retrospectively identified from a pro-
those who had not. spectively maintained IC/BPS database from 2006–2019, which included
Conclusions: Use of cannabis products by patients with IC/BPS is com- patient demographics, treatments, and ICSI/PI symptom score. Baseline
mon. Respondents who used cannabis products largely perceived them visit was defined as their first visit in our tertiary care clinic while change
to be beneficial for their symptoms with minimal side effects. Further in objective data was measured at first post-procedure clinic visit.
research should be directed towards determining if there is clinical utility Results: Of a total of 469 patients, 44 were identified as HL-IC/BPS.
for cannabis as a therapy for patients with IC/BPS. Median age of HL-IC/BPS cohort was 70 years old, all were Caucasian,
and 25% were male. Of the 44 patients with HLs, 22 received direct
MP-2.12 HL treatment: 15 fulguration only (F), two triamcinolone injection only
Triamcinolone acetate injections as treatment for Hunner’s lesions (T), and five both fulguration and triamcinolone injection (FT) over the
in bladder pain syndrome: Reducing pain treatment regimens course of the study period. Median age of F cohort was 70 years, while
Sarah R. Ferrara , Jennifer A. Locke , Lesley Carr , Sender Herschorn 1 T and FT cohorts had median age of 54 years. F cohort was 70% female,
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1 Urology, Sunnybrook Health Sciences Centre, University of Toronto, T cohort 100% female, and the FT cohort 60% female. Baseline ICSI
Toronto, ON, Canada for F, T, and FT cohorts were 16, 15, and 17, respectively, while their
Introduction: Bladder pain syndrome (BPS) is a difficult-to-manage, respective ICPI scores were 13, 12, and 14. There was a 73% clinically
chronic pain syndrome often requiring multiple treatments. A subgroup significant subjective improvement in the F cohort patients’ symptoms,
of patients with BPS have Hunner’s lesions — inflammatory lesions of the with a median change in ICSI/PI scores of 4 and 3 respectively. The small
bladder wall. We present our experience with triamcinolone injections T cohort subjectively improved but had missing data regarding objec-
into Hunner’s lesions for BPS management. tive evaluation. The FT cohort experienced a 100% subjective clinical
Methods: This is a retrospective analysis of 25 patients receiving triam- improvement following both fulguration and triamcinolone treatments.
cinolone injections into Hunner’s lesions identified from 2010–2018. The The median improvement in ICSI/PI scores were 7 and 8, respectively.
lesions were injected endoscopically with 0.5 cc injections of triamcino- Conclusions: Our clinical experience indicates that directly treating
lone acetate (40 mg/ml, max 10 mL). Pain resolution and change in pain the lesion in HL-IC/BPS with fulguration and/or triamcinolone injection
regimens were recorded at followup. Wilcoxon signed-rank test was used consistently results in high levels of objective and subjective symptom
to compare pain regimens before and after injections. improvement.
Results: Patients used a median of two pain treatments for BPS prior to
triamcinolone injection (interquartile range [IQR] 1–4). The most common

S90 CUAJ • June 2020 • Volume 14, Issue 6(Suppl2)