Can Hunners ulcers be seen during a cystoscopic exam without being under general anesthetic?

Yes. Hunners ulcers are there regardless of whether you do or do not distend the bladder. If doctor sees the Hunners ulcer while performing a cystoscopy under general or regional anesthesia, he has the diagnosis. Doctors will always biopsy the Hunners ulcer.
A Hunners ulcer looks like a red patch in the bladder. Microscopically, you see dense inflammation.
A Hunners ulcer is indistinguishable from carcinoma in situ, a form of bladder cancer, so these lesions must be biopsied.

Hunner’s ulcers (Hunner’s lesions) are a subtype of interstitial cystitis (IC). They are distinctive areas of inflammation on the bladder that characterize the IC. Hunner’s ulcers are the one diagnostic feature that clinches the IC diagnosis, but this form of IC affects only about 10 percent of patients. Patients with this form of IC have more severe symptoms than patients with nonulcerative IC.

To check for Hunner’s ulcers, your doctor will perform a procedure called cystoscopy.

The physicians use a cystoscope to look inside your bladder.