Guía práctica para el manejo y tratamiento ante la cistitis rádica

Martínez‐Rodríguez, R.; Calama, J. Areal; Satue, C. González; Macias, J. Sanchez; Fàbregas, M. Arzoz; Ramos, J. Gago; Arenas, S. Bayona; Servio, L. Ibarz; Roig, J.M. Saladié

doi:10.1016/j.acuro.2010.03.005

Cited by 9 publications

(2 citation statements)

References 38 publications

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“…La reducción en la densidad vascular y celular de la pared vesical conlleva hipoxia crónica del tejido y la consecuente respuesta inflamatoria con posterior fibrosis de la vejiga. La atrofia mucosa y la presencia de cicatrices y ulceraciones provocarán la mayoría de sus manifestaciones clínicas (10)(11)(12)(13).…”

Section: Discussionunclassified

Efficacy, tolerance and predictors of response to the treatment with hyperbaric oxygen therapy for patients with hemorrhagic radiation cystitis

Sarrió-Sanz¹,

Sánchez‐Caballero²,

Martínez-Cayuelas³

et al. 2022

Arch. Esp. Urol.

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The aim was to study the efficacy and tolerance in patients with haemorrhagic radiation-induced cystitis (HRC) treated with hyperbaric oxygen therapy (HOT) and analyze which factors were related to the response to the treatment. Material and methods: We performed a retrospective cohort study of patients treated with HOT for HRC symptoms in a provincial referral centre from 2010 to 2020. We evaluated clinical response to treatment, number of hospitalizations due to HRC and subjective response using the PGI-I questionnaire. Results: We treated 52 patients, with a median of 30 sessions, during 6 months and 40 months (6-68 months) of follow-up. 69.2% of patients responded completely and 21,2% partially. The 53.2% of patients improved before the first 10 sessions. Reduction of hospitalizations/per year due to haematuria from 2.8 to 1.1 (p=0,001). The 73,5% of patients stated that they were "very much better" or "much better" after treatment. During the follow-up, 15.4% of patients had recurrence of HRC. 9.6% of the patients required salvage cystectomy. The patients with a highest RTOG-EORTC scale had more risk to still with symptoms (OR 3.01 (IC95 1.48 -6.16). All patients were able to complete the proposed treatment plan with good tolerance to HOT. Conclusions: These results show the clinical benefit of HOT in the treatment of HRC, with a reduction of the number of hospitalizations and a subjective improvement. Resumen:Objetivo: conocer eficacia y tolerancia de la hiperoxigemia en cámara hiperbárica (THO) en pacientes con cistitis rádica hemorrágica (CRH) y analizar factores asociados a respuesta al tratamiento. Material y métodos: estudio de cohorte retrospectivo de pacientes tratados mediante THO por CRH en centro de referencia entre 2010 y 2020. Evaluamos respuesta clínica de la hematuria, número de ingresos hospitalarios por CRH y satisfacción subjetiva mediante cuestionario PGI-I. Resultados: tratamos 52 pacientes, mediana de 30 sesiones con 6 meses de tratamiento y 40 meses (6-68 meses) de seguimiento. El 69,2% obtuvo respuesta completa y el 21,2% respuesta parcial. El 53,2% mejoró antes de las 10 primeras sesiones. La reducción de los ingresos hospitalarios/año por hematuria fue de 2,8 a 1,1 (p=0,001). El 73,5% de pacientes señaló encontrarse "Mucho mejor" o "un poco mejor" tras el tratamiento. Durante el seguimiento, el 15,4% presentaron recurrencia de hematuria. Del total de la serie, 9,6% de pacientes precisó cistectomía de rescate. El análisis de supervivencia mostró una asociación entre el tiempo de desaparición de la hematuria y la clasificación de la escala RTOG-EORTC (OR 3,01 (IC95 1,48-6,16). Todos los pacientes pudieron finalizar el plan de tratamiento propuesto con buena tolerancia a la THO. Conclusiones: la THO muestra beneficio clínico en el tratamiento de la CRH, redujo los episodios de hospitalización por hematuria y mejoró la calidad de vida de los pacientes, con buena tolerancia al tratamiento.

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Section: Discussionunclassified

Efficacy, tolerance and predictors of response to the treatment with hyperbaric oxygen therapy for patients with hemorrhagic radiation cystitis

Sarrió-Sanz¹,

Sánchez‐Caballero²,

Martínez-Cayuelas³

et al. 2022

Arch. Esp. Urol.

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“…Approximately 85 % of patients with prostate cancer receiving external radiotherapy (74 Gy) and 24 % of patients with cervical carcinoma receiving brachytherapy develop acute radiogenic cystitis [ 2 , 3 ]. Recurrent haematuria, a severe symptom of cystitis, which requires surgical intervention, occurs in approximately 8 % of patients 3–6 months following radiation of the bladder [ 4 ] and is even more frequent in the interval of 3 months to 5 years. Cystitis is a common chemotherapy-associated complication following intravesical adjuvant therapy for urothelial malignancy.…”

Section: Introductionmentioning

confidence: 99%

Intravesical Glycosaminoglycan Replacement with Chondroitin Sulphate (Gepan® instill) in Patients with Chronic Radiotherapy- or Chemotherapy-Associated Cystitis

Schwalenberg

Berger

Horn³

et al. 2015

Clin Drug Investig

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Background and ObjectiveIntravesical instillation of glycosaminoglycans is a promising option for the treatment of chronic cystitis, as it supports the regeneration of the damaged urothelial layer. We investigated the efficacy of short-term intravesical chondroitin sulphate treatment (six courses of instillation) in patients with chronic radiotherapy- or chemotherapy-associated cystitis.MethodsThis prospective, observational study included patients with chronic radiotherapy- or chemotherapy-associated cystitis, who received six once-weekly intravesical instillations of 0.2 % chondroitin sulphate 40 mL. Every week, patients recorded their symptoms and their benefits and tolerance of treatment, using a self-completed questionnaire.ResultsThe study included 16 patients (mean age 68.5 years; 50 % male). During the study, a reduction in all evaluated parameters was observed. After one dose of chondroitin sulphate, symptom improvement was observed in 38 % of patients, and after the second dose, an additional 31 % of patients showed improvement. At week 6, 80 % of patients had either improved or were symptom free, and significant improvements in urinary urgency (p = 0.0082), pollakisuria (p = 0.0022), urge frequency (p = 0.0033) and lower abdominal pain (p = 0.0449) were observed. Haematuria, present in 9 of the 16 patients at baseline, was completely resolved in all cases after 6 weeks. The majority of patients (93 %) evaluated the tolerance of chondroitin sulphate as ‘good’ or ‘very good’. No treatment-related adverse events were reported.ConclusionIntravesical administration of chondroitin sulphate was effective for the treatment of radiotherapy- or chemotherapy-associated cystitis. Even short-term treatment appears to be effective in reducing symptoms and improving the quality of life of patients.

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