Haemorrhage is a frequent complication of radiation cystitis leading to emergency presentations in patients with prior pelvic radiation therapy. Standard initial patient management strategies involve resuscitation, bladder washout with clot evacuation and continuous bladder irrigation. Beyond this, definitive surgical treatment is associated with significant morbidity and mortality. Alternative less invasive management options for non-emergent haemorrhagic cystitis include systemic medical therapies, hyperbaric oxygen, intra-vesical therapies and laser ablation. However, evidence to support and compare treatment for haemorrhagic radiation cystitis is limited. Herein, a literature search pertaining to the current management of haemorrhagic cystitis was conducted. With evaluation of existing literature, this narrative review also provides a stepwise clinical algorithm to aid the urologist in treating patients presenting with complications associated with radiation cystitis. This article is protected by copyright. All rights reserved.
BJU international. 2018 Aug 16 [Epub ahead of print]
Claire Pascoe, Catriona Duncan, Benjamin W Lamb, Niall F Davis, Thomas H Lynch, Declan G Murphy, Nathan Lawrentschuk
Department of Cancer Surgery, Peter MaCallum Cancer Centre, Melbourne, Australia., Department of Urology, Austin Health Heidelberg, Australia., Department of Urology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom., Department of Urology, St James Hospital, Dublin 8, Ireland.