Comments to Editorial by J. Curtis Nickel. It is premature to categorize Hunner lesion interstitial cystitis as a distinct disease entity. Scandinavian Journal of Urology 2020, Vol. 54, No. 2, 99–100; https://doi.org/10.1080/21681805.2020.1744714
Abstract
We would like to thank Dr. Nickel for his comments (J. Curtis Nickel (2020) It is premature to categorize Hunner Lesion interstitial cystitis as a distinct disease entity, Scandinavian Journal of Urology, 54:2, 99-100, DOI: 10.1080/ 21681805.2020.1744714) regarding our publication: Hunner lesion disease differs in diagnosis, treatment and outcome from bladder pain syndrome: an ESSIC working group report in SCANDINAVIAN JOURNAL OF UROLOGY 2020, VOL. 54, NO. 2, 91–98 https://doi.org/10.1080/21681805.2020.1730948. We disagree with him vehemently. It has been 33 years since Fall and coworker’s paper ‘Chronic interstitial cystitis: a heterogeneous syndrome’ which described ‘marked clinical differences between ulcerative and nonulcerative interstitial cystitis’ [1] appeared in the literature. This was the first publication to call for evaluating these conditions separately in clinical studies and noted the different clinical pathways for treatment. Much literature has been published to support this concept. Failure to act earlier is a major reason that no new treatments have been found effective enough to warrant FDA approval since the 1996 approval of sodium pentosan polysulfate (Elmiron), which itself has failed two subsequent phase-four clinical efficacy trials. While the symptoms of Hunner lesion positive and negative patients may be similar, that is no reason not to continue the efforts to phenotype the disorder and discover what treatments may benefit individual phenotypes.…
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