**5. Conclusion**

Although there is no definite treatment for IC/BPS, endoscopic treatment can be considered for Hunner lesion type IC/BPS. To confirm the presence of Hunner lesion, cystoscopy should be performed in patients with suspected IC/BPS. When performing cystoscopy, the bladder should not be inflated too much to prevent false-positive findings or bleeding due to mucosal fissure and to accurately diagnose Hunner lesion. Various intravesical therapies, including HA, CS, and DMSO, have been used for IC/BPS and are more effective in terms of anti-inflammatory effects and GAG layer replenishment in patients with Hunner lesion than patients without Hunner lesion. Overall, endoscopic ablation for Hunner lesion is an effective and minimally invasive treatment for patients with Hunner lesion type IC/BPS; this treatment strategy significantly reduces pain and improves voiding symptoms. Mucosal cracks that occur during hydrodistension are not real Hunner lesion, and we do not recommend performing hydrodistension first during endoscopic ablation. Repeated ablation does not suppress recurrence but does not reduce the therapeutic efficacy. There are various methods for endoscopic ablation; the main methods are coagulation or resection of Hunner lesion, and both are good treatment modalities to relieve the symptoms of Hunner lesion IC/BPS and improve quality of life. IC/ BPS with Hunner lesion is a progressive disease, and it is necessary to establish a treatment protocol such as adjuvant intravesical treatment to reduce the risk of recurrence after transurethral ablation.
