A Case of Severe Hemorrhagic Cystitis Caused by Melphalan with Successful Bladder Preservation by Ligation of Bilateral Internal Iliac Arteries

Takeuchi, Takumi; Zaitsu, Masayoshi; Mikami, Koji; Takeshima, Yuta; Matsunaga, Takashi; Okamoto, Naohiko; Imao, Sadao

doi:10.1155/2010/569138

Cited by 4 publications

(3 citation statements)

References 7 publications

(6 reference statements)

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“…в роботизированной методике [9], и продолжена рядом исследователей [10,11]. Выполнение такого рода маневра отмечалось также в 2010 г. при оказании хирургического пособия по поводу геморрагического цистита, вызванного множественной миеломой и осложненным массивным кровотечением на фоне химиотерапевтического лечения производными бис-β-хлорэтиламинамелфаланом (мелфалан) [12]. В 2012 г. тем же автором было дважды предпринято успешное пережатие ВПА зажимами типа «Bulldog» с целью снижения риска массивной кровопотери при энуклеации, с последующим получением образцов объемом 159 и 97 г. соответственно [13].…”

Section: Discussionunclassified

Arterial-mediated modifications of surgical treatment for benign prostatic hyperplasia.

Volkov,

Tereshchenko,

Stepanchenko

et al. 2023

ECU

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Introduction. Benign prostatic hyperplasia (BPH) still stays one of the most common diseases in the male population. Aim of research. To compare efficacy of 3 surgical treatments (laparoscopic retropubic simple prostatectomy combined with provisional clamping of internal iliac arteries and urethrocystoanastomosis [LRP+CIIA+UCA], open [ОAE] and laparoscopic [LAE] Millins’s simple prostatectomy) of benign prostatic hyperplasia (BPH). Materials and methods. 48 patients who underwent surgical treatment of benign prostatic hyperplasia in theNational Research Centre of Endocrinology of the Russian Ministry of Health have been observed during period since 2021 until 2022; 16 patients have been underwent LRP+CIIA+UCA, 16 – ОAE, 16 – LAE. Pre-operative observation included such parameters as body mass index, PSA level, prostatic volume, IPSS score, quality of life (QoL) score, maximal urinary flow rate (Qmax), volume of residual urine, erectile function score (IIEF-5). Operation longevity, catheterization and hospitalization period time, complications rate (Clavien-Dindo I, II, III degree) and blood loss have been evaluated during operative and early postoperative period. Efficacy of surgical treatment of BPH has been found as summary of all included parameters. Results. Despite relatively long period of operation, providing of LRP+CIIA+UCA managed to decrease blood loss (p<0,046), catheterization (p=0,001) and hospitalization (p=0,001) period, complications rate (Clavien-Dindo I, II, III degree). LRP+CIIA+UCA triggers to more expressed symptomatic regression (LRP+CIIA+UCA=15 [93,75%]; ОAE=13[81,25%]; LAE=11[68,75%], p=0,001) and clinical remission (LRP+CIIA+UCA=14 [87,5%]; ОAE=11 [68,75%]; LAE=10 [62,5%], p<0,001) after 6 months against to ОAE and LAE. Conclusions. Laparoscopic retropubic simple prostatectomy combined with provisional clamping of internal iliac arteries and urethrocystoanastomosis has shown to be more effective than open (ОAE) and laparoscopic (LAE) Millin’s simple prostatectomy due to decreased blood loss, shortened catheterization and hospitalization period, prevention of lower urinary tract cicatricial deformity.

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Section: Discussionunclassified

Arterial-mediated modifications of surgical treatment for benign prostatic hyperplasia.

Volkov,

Tereshchenko,

Stepanchenko

et al. 2023

ECU

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“…Interventional embolization of bilateral internal iliac arteries is conducted for uncontrollable bladder or prostate bleeding [ 3 ]. We have controlled massive bladder bleeding in a case of severe, potentially life-threatening hemorrhagic cystitis possibly caused by an anticancer drug, melphalan, by ligation of the bilateral internal iliac arteries [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Transient Occlusion of Bilateral Internal Iliac Arteries Facilitates Bloodless Operative Field in Subcapsular Prostatectomy

Takeuchi

Zaitsu

Mikami

et al. 2012

Case Reports in Medicine

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Transurethral resection of the prostate is the gold standard of surgical treatment for benign prostatic hyperplasia (BPH). Nevertheless, open subcapsular prostatectomy is still performed for large BPH. While enucleation of prostatic adenoma is being performed, unneglectable bleeding can occur and surgeons need to rush to remove adenomas, often using fingers and in a blinded fashion. The blood supply to the prostatic capsule and adenoma can be reduced to a marked extent in subcapsular prostatectomy if the bilateral internal iliac arteries are transiently occluded. Thus, a bloodless operative field is reasonably acquired during enucleation of adenoma, which would, otherwise, be a cause for concern to surgeons due to bleeding. It is not always applicable, but it could be an option if the estimated volume of BPH is more than 100 mL. In two cases, bilateral internal iliac arteries were occluded with Bulldog clamps, and then adenomas of 159 and 97 g were enucleated.

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“…76 Haemorrhagic cystitis is also rarely seen with melphalan. 66 Monitoring for patients on melphalan includes: 76 • Complete blood count should be performed at the start of therapy and before each subsequent dose, and further therapy should be withheld until counts have sufficiently recovered (leukocytes <3,000/μL and platelets <100,000/μL). Clinicians should consider adjusting dose based on blood counts at their lowest point and on the day of treatment.…”

Section: Side Effectsmentioning

confidence: 99%

Oral Therapies for Multiple Myeloma

Singh¹,

Kumar²

2022

Oncology &Amp; Haematology

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Multiple myeloma is a haematological cancer that needs continuous long-term management for improved outcomes and survival. Over the last few decades, medical therapies for myeloma have improved considerably, with several new drug classes becoming available. Oral therapies, especially when used in combinations, are more convenient than intravenous therapies, and limit the number of clinic visits. Oral therapies include thalidomide, lenalidomide, pomalidomide, ixazomib, panobinostat, selinexor, venetoclax, melphalan and cyclophosphamide. Cytopenias were the most common adverse events with the immunomodulatory drugs panobinostat, selinexor and venetoclax, while skin rash was seen commonly with ixazomib and lenalidomide. Oral regimens are imperative during a global pandemic and can be managed over telemedicine visits rather than outpatient infusions and injections, reducing the risk of exposure and infection. It is important that patients monitor their side effects and report them to their healthcare providers at the earliest opportunity. We review available oral regimens and their combinations for effective management of myeloma.

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A Case of Severe Hemorrhagic Cystitis Caused by Melphalan with Successful Bladder Preservation by Ligation of Bilateral Internal Iliac Arteries

Cited by 4 publications

References 7 publications

Arterial-mediated modifications of surgical treatment for benign prostatic hyperplasia.

Arterial-mediated modifications of surgical treatment for benign prostatic hyperplasia.

Transient Occlusion of Bilateral Internal Iliac Arteries Facilitates Bloodless Operative Field in Subcapsular Prostatectomy

Oral Therapies for Multiple Myeloma

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