Hunner Lesion (formerly Known as Hunner’s Ulcer)

History Guy Leroy Hunner, a Boston gynaecologist, described this inflammatory bladder disease a century ago in great detail for the first time in a series of papers, the first being published in 1914 (republished in 1915). In this first paper he writes: “While cystoscopy usually reveals only one inflammatory spot, there may be two or three granulation areas near together or somewhat separated, and operation usually reveals a more extensive area of inflammation than was appreciated by cystoscopy. The ulcer area may be easily overlooked and the attention may first be arrested by an area of dead white scar tissue. In the neighbourhood of this scar-looking area, one sees one or more areas of hyperemia which, on being touched with a dry cotton pledget, or with the end of the speculum, bleed and first show their character as ulcers. In other cases, or perhaps at subsequent examination on the same case, the ulcer may be well defined as a deeply red area with granulating base and with congested vessels surrounding the area. In none of the cases has an individual ulcer area been more than a half centimetre in diameter, although two or three such ulcers have at times been grouped in a larger inflammatory area.”