# A Case of Interstitial Cystitis With Hunner Lesions Involving Bilateral Ureters

## TL;DR

A rare case of interstitial cystitis with Hunner lesions affecting the upper urinary tract in a 51-year-old woman is reported.

## Contribution

This case highlights the unusual involvement of bilateral ureters in interstitial cystitis with Hunner lesions.

## Key findings

- The patient developed bilateral ureteral stenosis and hydronephrosis linked to IC/HL.
- Histological findings in the ureters matched chronic inflammatory changes seen in bladder lesions.
- Corticosteroid treatment did not resolve ureteral stenosis despite improvement in bladder symptoms.

## Abstract

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.

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.

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