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Radiation-induced haemorrhagic cystitis
J P Crew1, C R Jephcott, J M Reynard
1Department of Urology, Churchill Hospital, Oxford, UK. jeremy@crew35.freeserve.co.uk
European Urology
|August 31, 2001
Summary
Radiation-induced hemorrhagic cystitis is rare but serious. Early, aggressive treatment is recommended due to limited effective options for this progressive condition.
Area of Science:
- Urology
- Radiation Oncology
Background:
- Radiation-induced hemorrhagic cystitis (RIHC) is a potential complication of pelvic radiotherapy.
- While relatively rare, RIHC can be relentlessly progressive and difficult to manage.
Purpose of the Study:
- To review the current literature on the frequency and management of severe hemorrhagic radiation-induced cystitis.
Main Methods:
- A comprehensive Medline search was conducted from 1966 to 1999.
- 309 English-language articles were identified and their abstracts and full texts reviewed.
Main Results:
- Severe hemorrhagic cystitis occurs in less than 5% of patients post-pelvic irradiation, with incidence increasing over time.
- Treatment options are varied and suboptimal, including bladder irrigation, cystodiathermy, intravesical agents, hyperbaric oxygen, embolization, diversion, and cystectomy.
- No single management strategy is universally successful, often necessitating a stepwise increase in treatment intensity.
Conclusions:
- Existing literature on RIHC is largely retrospective with small patient cohorts and diverse treatment modalities.
- The lack of randomized controlled trials prevents definitive management guidelines.
- Early and aggressive treatment is likely warranted for patients with radiation-induced hemorrhagic cystitis.