Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic pelvic pain, urinary urgency, and frequency. Symptoms exacerbated by bladder filling and relieved by voiding. Reports nocturia [X] times per night. Hunner lesions previously identified/suspected on cystoscopy. Pain score [X]/10. No history of UTI, hematuria, or recent instrumentation.
Clinical Examination Findings
Abdominal exam: Soft, non-distended, localized suprapubic tenderness upon deep palpation. No guarding or rebound. Genitourinary exam: External genitalia normal, no urethral discharge or caruncle. Pelvic floor musculature: Hypertonic with tenderness at trigger points.
Treatment Protocol
Plan: 1. Cystoscopy with hydrodistention and fulguration/laser ablation of Hunner lesions. 2. Intravesical instillation of [e.g., DMSO/Heparin/Lidocaine]. 3. Oral therapy: Pentosan polysulfate sodium [X] mg TID. 4. Pelvic floor physical therapy referral. 5. Dietary modification (avoidance of bladder irritants).