Related Experiment Video
Updated: Sep 6, 2026

Evaluation of Biomaterials for Bladder Augmentation using Cystometric Analyses in Various Rodent Models
Published on: August 9, 2012
A bladder matter: redefining the grading system for pediatric hemorrhagic cystitis
Catherine L Robey1,2, Michelle Higgins3, Mohammad Elmojtaba Gumma3
1Robert D. Jeffs Division of Pediatric Urology, James Buchanan Brady Urological Institutions, Johns Hopkins Hospital, Johns Hopkins Medical Institutions, Charlotte Bloomberg Children's Hospital, Baltimore, MD, USA. crobey1@jh.edu.
Introduction:
Pediatric hemorrhagic cystitis (HC) is a morbid, understudied condition ranging from microscopic hematuria to life-threatening hemorrhage. Existing grading systems, based on adult populations, fail to account for pediatric-specific factors and lack predictive value. This study aimed to identify risk factors for severe HC and propose a modernized, predictive grading scale.
Methods:
We retrospectively reviewed patients ≤ 18 years with gross hematuria due to HC at our institution (2014-2024). Bladder toxic exposures, treatments, and outcomes were analyzed. Existing grading systems were applied to assess utility. Chi-square, Mann-Whitney, and logistic regression identified predictors of surgical intervention (p < 0.05).
Results:
Ninety-three patients were included. The strongest predictors of surgical intervention were male sex (p = 0.023), history of bone marrow transplantation (BMT) (p = 0.031), busulfan exposure (p = 0.011), graft versus host disease (GVHD) (p = 0.027), BK virus (p = 0.01), AML (p = 0.043), and clot volume of >/= 10% of estimated bladder capacity (OR 34.8, p < 0.0001).
Conclusion:
We propose an updated grading system incorporating ultrasound findings to guide management. This revised scale improves risk stratification, guides timely urologic consultation, and standardizes clinical decision-making. Prospective validation is warranted.
Related Concept Videos
Imaging Studies VI: Voiding Cystourethrography and Cystography
Urinary Bladder
In males, the bladder is situated in front of the rectum, while in females, it is positioned anterior to the vagina and uterus. The bladder floor contains an inverted triangular area called the trigone, defined by the two ureteric...
Anatomy of the Genitourinary System II: Bladder and Urethra
Urologic Endoscopic Procedure: Cystoscopic Examination
Acute Pyelonephritis II: Diagnostic Studies and Management
Microbiota of the Urogenital Tract
