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[A Case of Refractory Hemorrhagic Cystitis in which Bleeding Control was Finally Achieved by Cystectomy]

Wakako Yorozuya1, Atsushi Takahashi1, Akio Takayanagi1

  • 1Hakodate Goryokaku Hospital.

Hinyokika Kiyo. Acta Urologica Japonica
|December 14, 2018
PubMed

Insights

Cyclophosphamide treatment for nephrotic syndrome can cause severe hemorrhagic cystitis. A patient ultimately required cystectomy to control intractable hematuria, highlighting the importance of timely surgical intervention.

Area of Science:

  • Urology
  • Nephrology
  • Oncology

Background:

  • Long-term cyclophosphamide and steroid therapy is used for nephrotic syndrome.
  • Hemorrhagic cystitis is a known complication of cyclophosphamide treatment.

Observation:

  • A 60-year-old man with a history of nephrotic syndrome presented with gross hematuria.
  • Cystoscopy revealed diffuse hemorrhagic cystitis, diagnosed as cyclophosphamide-induced.

Findings:

  • Despite blood transfusion, bladder irrigation, hyperbaric oxygen, electric coagulation, and increased steroids, hematuria persisted.
  • The patient underwent cystectomy for intractable hemorrhagic cystitis.

Implications:

  • Cystectomy, while a last resort, can effectively manage severe cyclophosphamide-induced hemorrhagic cystitis.
  • Timely surgical decision-making is crucial to improve patient quality of life and avoid prolonged morbidity.

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