Hunner Ulcer of the Bladder*

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In 1836, Mercier first called attention to ulcerations which develop in the floor of the loculate bladder, and similar cases were reported by Tait in 1870. In 1900, Fenwick compared chronic, solitary simple ulcer of the bladder with ulcer of the stomach but Rakitansky and Tait previously had made this comparison. In 1914, Hunner reported eight cases of “a rare type of bladder ulcer in women.” He described the symptoms and the pathologic appearance of the lesion and suggested that pericystitis might be the cause of a primary lesion of which the bladder ulcer was a secondary manifestation. Other cases have been reported by Nitze, Kretschmer, Bumpus and Meisser, Hinman, Furness, Keene, Peterson and Hager, Folsom, Higgins, Eisenstaedt and McDougall, and Meads.

Various authors have referred to this clinical entity described by Hunner and designated by many as Hunner ulcer of the bladder, as interstitial cystitis, elusive ulcer, pan-mural cystitis and submucous fibrosis.

Etiology: Besides having been the first clearly to define this lesion, Hunner was also the first to recognize a possible relationship between focal infection and the ulcer. It is now a generally accepted fact that infection in the teeth, tonsils, adenoids or nasal sinuses may be carried to the bladder by the hematogenous route. In 1931, Meisser and Bumpus added further proof to the theory that infection is an etiologic factor when, by experimental research, they demonstrated that certain streptococci which were present in various foci of infection had a selective affinity for the urinary tract and. . .



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