Hyperbaric, Radiation Cystitis

Excerpt

Radiation Cystitis is a term used to describe the side effect of inflammation and subsequent destruction to the normal anatomy of the urinary bladder at the cellular level after the use of radiation in the treatment of multiple cancer types, including, most commonly, pelvic cancers. Radiation therapy can be used for primary bladder cancer as well as for tumors in many organs surrounding the bladder, such as the colon, rectum, ovaries, uterus, and prostate. When the primary tumor is not located in the bladder, this leads to unintentional radiation exposure to the healthy bladder tissue.  Damage from the treatment can either be acute (less than six months from radiation therapy completion) or delayed (more than six months after treatment) and can have varying levels of irritation and functional impairment to the bladder mucosa. If on the mild end of the spectrum, symptoms may include increased frequency, urgency, and possibly some dysuria. Infection should be ruled out with a urinalysis which may show microscopic hematuria. These symptoms can resolve over time.  On the other end of the spectrum, patient's may experience symptoms such as urinary incontinence, gross hematuria, and progression of damage to the extent of fistula formation or necrotic bladder tissue. The treatment varies on the degree of symptoms. Overall, radiation cystitis can be detrimental to a patient's wellbeing after already having gone through a great deal in regards to cancer treatment. Providers are becoming more aware of the drastic effects a dysfunctional bladder can have on overall quality of life, but more investigation needs to be performed to best tailor radiation therapy while avoiding side effects such as this one. 

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Nicholas Horan, Jeffrey S. Cooper

Gundersen Lutheran Hospital, University of Nebraska Medical Center

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