Canadian Urological Association Best Practice Report: Diagnosis and management of radiation-induced hemorrhagic cystitis

Goucher, George; Saad, Fred; Lukka, Himu; Kapoor, Anil

doi:10.5489/cuaj.5788

Cited by 10 publications

(19 citation statements)

References 67 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…An increased proliferation of the urothelium and damage to the tight cellular junctions are seen following radiation therapy. 109 The normal polysaccharide layer is also damaged and, in combination, these effects lead to a pathologically increased permeability of the urothelium, allowing metabolites and bacteria to enter the underlying tissue. 93 This altered permeability is hypothesized to play a major role in the development of late radiation-induced injuries.…”

Section: Radiation-induced Injuries In the Urinary Bladdermentioning

confidence: 99%

“…149 There have been attempts to treat late radiation cystitis with other intravesical agents, such as antifibrinolytic agents, silver nitrate, and prostaglandins, but only in small studies and with uncertain results. 109 Systemically administered agents have also been tried, such as estrogen, macrophage regulators (WF10), and tranexamic acid, but none have proven to be effective. 109 In the most severe cases, with bleedings requiring transfusions, transarterial embolization might be attempted.…”

Section: Treatment Optionsmentioning

confidence: 99%

“…109 Systemically administered agents have also been tried, such as estrogen, macrophage regulators (WF10), and tranexamic acid, but none have proven to be effective. 109 In the most severe cases, with bleedings requiring transfusions, transarterial embolization might be attempted. Cystectomy is the last resort and is associated with a high risk of morbidity and mortality.…”

Section: Treatment Optionsmentioning

confidence: 99%

See 2 more Smart Citations

Radiation-induced cystitis treated with hyperbaric oxygen therapy (RICH-ART): a randomised, controlled, phase 2–3 trial

Oscarsson

Müller

Rosén

et al. 2019

The Lancet Oncology

View full text Add to dashboard Cite

Introduction Cancer is affecting a growing number of persons. Still, the treatment and survival of cancer is improving. Radiation therapy is used in the treatment of cancer. Late radiation-induced injuries afflict 5-15% of irradiated patients. The urinary bladder and bowel may be affected after irradiation of cancer in the pelvic region. Symptoms can be severe, with impaired health related quality of life (HRQoL). Hyperbaric oxygen therapy (HBOT) involves breathing oxygen at high ambient pressure. HBOT can reverse radiation-induced injuries, alleviate patient-perceived symptoms, and improve HRQoL. We aimed to clarify the effects of HBOT on late radiation-induced injuries in the urinary bladder and bowel, and to clarify some of the underlying mechanisms through which HBOT exerts its effects. Methods A prospective cohort study assessed effects of HBOT on patient-perceived symptoms (Paper I). A rat study assessed reversal of radiation-induced stress with HBOT (Paper II). A methodological experiment assessed reversal of HBOT on cellular death induced by radiation (Paper III). A multi-center, randomized, controlled trial assessed patient-perceived symptoms, HRQoL, and objective clinical outcomes (Paper IV). Result HBOT can alleviate patient-perceived symptoms, reduce objective findings, and improve HRQoL in patients affected by late radiation-induced injuries (Paper I, IV). Oxidative stress and downstream effects, induced by the irradiation, can be reversed by HBOT (Paper II). Paper III outlines a method for studies on urothelial cells exposed to radiation and HBOT. Conclusion HBOT can reduce radiation-induced oxidative stress and inflammatory response. HBOT can reverse injuries induced by radiation therapy to the pelvic region, alleviate patient-perceived symptoms and lead to improved HRQoL.

show abstract

Section: Radiation-induced Injuries In the Urinary Bladdermentioning

confidence: 99%

Section: Treatment Optionsmentioning

confidence: 99%

Section: Treatment Optionsmentioning

confidence: 99%

See 1 more Smart Citation

Radiation-induced cystitis treated with hyperbaric oxygen therapy (RICH-ART): a randomised, controlled, phase 2–3 trial

Oscarsson

Müller

Rosén

et al. 2019

The Lancet Oncology

View full text Add to dashboard Cite

show abstract

“…Aluminium toxicity is rare, but is of particular concern in patients with existing renal impairment, which may limit the excretion of serum aluminium [8]. As a practical, fast-acting and well-tolerated therapy, intravesical alum has been recommended as a first line therapy for haemorrhagic cystitis in inpatients with normal renal function who do not respond to conventional bladder irrigation [9].…”

Section: -Microscopic Haematuria 2-macroscopic Haematuria 3-macroscomentioning

confidence: 99%

“…Hyaluronic acid (HA), a mucopolysaccharide with immunomodulatory properties, has been recommended as an intravesical therapy. Instillation into the bladder is thought to aid in the repair of the glycoaminoglycan layer, an important urothelial defence mechanism against toxins and bacterial adherence [5,7,9]. Six doses of 40 mg hyaluronic acid over 3 months, each retained within the bladder for 20 min, have been found to be at least as efficacious as hyperbaric oxygen therapy for reducing bleeding in haemorrhagic cystitis and adverse effects are uncommon [10].…”

Section: -Microscopic Haematuria 2-macroscopic Haematuria 3-macroscomentioning

confidence: 99%

Haemorrhagic cystitis due to cytomegalovirus in a patient with AIDS

et al. 2020

View full text Add to dashboard Cite

Background: Cytomegalovirus-related infections are commonly seen in immunocompromised patients. However, haemorrhagic cystitis is an exceptionally rare associated manifestation. We present an unusual case of cytomegalovirus-related haemorrhagic cystitis in a patient with acquired immune deficiency syndrome (AIDS). Case presentation: A 33-year-old HIV-positive female presented with acute gross haematuria and suprapubic pain. Cystoscopy revealed features suggestive of haemorrhagic cystitis with clots in the bladder and an ulcerative lesion on the left lateral wall which was biopsied. Histology demonstrated the presence of enlarged cells containing eosinophilic intranuclear and ill-defined amphophilic intracytoplasmic inclusions. Immunohistochemistry was positive for cytomegalovirus. Conclusion: This case appears to be the first of its kind reported in South Africa highlighting the importance of considering cytomegalovirus as a potential infectious aetiology in AIDS patients with haematuria. Bladder irrigation with normal saline with or without clot evacuation combined with Ganciclovir are associated with good outcome.

show abstract

Die blutende Strahlenblase – mögliche Therapieoptionen!

Nuhn

Thüroff

2022

Urologie

View full text Add to dashboard Cite

Canadian Urological Association Best Practice Report: Diagnosis and management of radiation-induced hemorrhagic cystitis

Cited by 10 publications

References 67 publications

Radiation-induced cystitis treated with hyperbaric oxygen therapy (RICH-ART): a randomised, controlled, phase 2–3 trial

Radiation-induced cystitis treated with hyperbaric oxygen therapy (RICH-ART): a randomised, controlled, phase 2–3 trial

Haemorrhagic cystitis due to cytomegalovirus in a patient with AIDS

Die blutende Strahlenblase – mögliche Therapieoptionen!

Contact Info

Product

Resources

About