Endoscopic neodymium:YAG laser treatment of radiation-induced hemorrhagic cystitis

Hemorrhagic cystitis is a debilitating complication of radiation therapy for pelvic malignancy. Forty-two such patients with intractable hematuria underwent endoscopic Nd:YAG laser coagulation under local anesthesia between January 1990 and July 1992. The laser power was kept at < or = 30 W and the pulse duration < or = 3 s. Control of bleeding was achieved in 39 patients after one sitting and in 2 patients after two sittings of laser treatment. There were no complications of the procedure and recurrence of bleeding was not seen in any of the patients achieving CR at a mean follow-up period of 14 months. With modifications in the safety guidelines, we recommend laser treatment as the initial procedure of choice in patients with hemorrhagic radiation cystitis.