Prevention of ifosfamide-induced hemorrhagic cystitis by continuous bladder irrigation

To prevent hemorrhagic cystitis induced by ifosfamide, continuous bladder irrigation with 3,000 ml. of saline per day was performed in 8 patients. Ifosfamide was given by an intravenous infusion one to two hours at a dose of either 1,600 to 1,950 mg./m2 daily for three days, or 1,430 to 1,480 mg./m2 daily for five days. Gross hematuria was induced in none and microscopic hematuria in one during 24 courses of treatment. There was no complication associated with catheter placement, other than urethral discomfort in 1 patient. Thus this appears to be a useful and effective method.