Claire Pascoe1,2, Catriona Duncan2,3, Benjamin W Lamb4, Niall F Davis2, Thomas H Lynch5, Declan G Murphy1, Nathan Lawrentschuk1,2. 1. Department of Cancer Surgery, Peter MaCallum Cancer Centre, Melbourne, Vic., Australia. 2. Department of Urology, Austin Health Heidelberg, Heidelberg, Vic., Australia. 3. North Eastern Urology, Heidelberg, Vic., Australia. 4. Department of Urology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. 5. Department of Urology, St James Hospital, Dublin 8, Ireland.
Abstract
INTRODUCTION: 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 (HBO), intravesical therapies and laser ablation. However, evidence to support and compare treatment for haemorrhagic radiation cystitis is limited. METHODS: Herein, a literature search pertaining to the current management of haemorrhagic cystitis was conducted. RESULTS: In total, 23 studies were included in this review with 2 studies reviewing systemic therapy, 7 studies evaluating HBO therapy, 10 studies investigating a variety of intravesical therapies and the remaining 4 were relating to ablative therapies. Across these studies, the patient groups were heterogenous with small numbers and variable follow up periods. CONCLUSION: 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.
INTRODUCTION: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 (HBO), intravesical therapies and laser ablation. However, evidence to support and compare treatment for haemorrhagic radiation cystitis is limited. METHODS: Herein, a literature search pertaining to the current management of haemorrhagic cystitis was conducted. RESULTS: In total, 23 studies were included in this review with 2 studies reviewing systemic therapy, 7 studies evaluating HBO therapy, 10 studies investigating a variety of intravesical therapies and the remaining 4 were relating to ablative therapies. Across these studies, the patient groups were heterogenous with small numbers and variable follow up periods. CONCLUSION: 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.
Authors: Carole Helissey; Sophie Cavallero; Clément Brossard; Marie Dusaud; Cyrus Chargari; Sabine François Journal: Cells Date: 2020-12-24 Impact factor: 6.600
Authors: Stefania Zuppone; Andrea Bresolin; Antonello E Spinelli; Giuseppe Fallara; Roberta Lucianò; Federico Scarfò; Fabio Benigni; Nadia Di Muzio; Claudio Fiorino; Alberto Briganti; Andrea Salonia; Francesco Montorsi; Riccardo Vago; Cesare Cozzarini Journal: Front Oncol Date: 2020-10-22 Impact factor: 6.244