Urologic complications of radiation therapy for gynecologic malignancies

Radiation Cystitis

“…Reduced healing capacity due to ischemia makes the bladder susceptible to mucosal ulceration, hemorrhage, occasional spontaneous perforation and fistula formation. 2,3 Bladder tissue examined histologically during the chronic phase of radiation cystitis, particularly in patients with gross hematuria, may exhibit surface denudation, ulceration, stromal hem- orrhage and edema, fibrin deposition in stroma and blood vessels, fibrosis, and acute and chronic inflammation, sometimes with prominent eosinophilia (figs. 1 and 2).…”

“…Gross hematuria occurs in up to 7.7% of patients and although it is more common in the first 6 weeks after therapy, it has been reported as long as 14 years later. [1][2][3] Acute and subacute phase symptoms are generally self-limiting. Bladder tissue examined histologically during the acute and subacute phases typically shows varying degrees of urothelial desquamation, and atypia of residual urothelium comprising mainly nuclear and cytoplasmic vacuolization.…”