Skip to main content
SpringerLink
Log in
Book cover

Genitourinary Pain And Inflammation pp 351–366Cite as

Hemorrhagic and Radiation Cystitis

  • Chapter

  • 1305 Accesses

Part of the book series: Current Clinical Urology ((CCU))

Summary

Hemorrhagic cystitis is the endpoint of a variety of pathologies causing damage to, and diffuse bleeding from, the urothelial lining of the bladder. Etiologies include an array of infections, toxins, pelvic radiation, drugs, and occasionally systemic diseases. In simple as well as complex scenarios, the algorithm for treatment is the same. Underlying causes should be identified and treated, coagulopathies, if present, must be corrected, and supportive care aimed at arresting or controlling the hematuria is instituted. This chapter gives an approach to the various etiologies and management strategies for hemorrhagic cystitis.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   89.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Reference

  1. Ronald AR. Current concepts in the management of urinary tract infections in adults. Med Clin North Am 1984;68(2):335–49.

    PubMed  CAS  Google Scholar 

  2. Kauffman CA. Candiduria. Clin Infect Dis 2005;41(S6):S371–6.

    Article  PubMed  Google Scholar 

  3. Kauffman CA, Vazquez JA, Sobel JD, et al. Prospective multicenter surveillance study of funguria in hospitalized patients. The National Institute for Allergy and Infectious Diseases (NIAID) Mycoses Study Group. Clin Infect Dis 2000;30(1):14–8.

    Article  PubMed  CAS  Google Scholar 

  4. Fisher JF, Chew WH, Shadomy S, Duma RJ, Mayhall CG, House WC. Urinary tract infections due to Candida albicans. Rev Infect Dis 1982;4(6):1107–18.

    PubMed  CAS  Google Scholar 

  5. Kambal A. The relation of urinary bilharziasis to vesical stones in children. Br J Urol 1981;53(4):315.

    PubMed  CAS  Google Scholar 

  6. Shokeir AA. Squamous cell carcinoma of the bladder: Pathology, diagnosis and treatment. BJU Int 2004;93(2):216–20.

    Article  PubMed  CAS  Google Scholar 

  7. Fuloria HK, Jaiswal MS, Singh RV. Primary hydatid cyst of bladder. Br J Urol 1975;47(2):192.

    Article  PubMed  CAS  Google Scholar 

  8. Mufson MA, Belshe RB. A review of adenoviruses in the etiology of acute hemorrhagic cystitis. J Urol 1976;115(2):191–4.

    PubMed  CAS  Google Scholar 

  9. Numazaki Y, Kumasaka T, Yano N, et al. Further study on acute hemorrhagic cystitis due to adenovirus type 11. N Engl J Med 1973;289(7):344–7.

    Article  PubMed  CAS  Google Scholar 

  10. Hofland CA, Eron LJ, Washecka RM. Hemorrhagic adenovirus cystitis after renal transplantation. Transplant Proc 2004;36(10):3025–7.

    Google Scholar 

  11. Kawakami M, Ueda S, Maeda T, et al. Vidarabine therapy for virus-associated cystitis after allogeneic bone marrow transplantation. Bone Marrow Transplant 1997;20(6):485–90.

    Article  PubMed  CAS  Google Scholar 

  12. Heritage J, Chesters PM, McCance DJ. The persistence of papovavirus BK DNA sequences in normal human renal tissue. J Med Virol 1981;8(2):143–50.

    Article  PubMed  CAS  Google Scholar 

  13. Reploeg MD, Storch GA, Clifford DB. Bk virus: A clinical review. Clin Infect Dis 2001;33(2):191–202.

    Article  PubMed  CAS  Google Scholar 

  14. Khakpour M, Nik-Akhtar B. Epidemics of haemorrhagic cystitis due to influenza A virus. Postgrad Med J 1977;53(619):251–3.

    PubMed  CAS  Google Scholar 

  15. Walker RD. Cyclophosphamide induced hemorrhagic cystitis. J Urol 1999;161(6):1747.

    Article  PubMed  CAS  Google Scholar 

  16. deVries CR, Freiha FS. Hemorrhagic cystitis: A review. J Urol 1990;143(1):1–9.

    PubMed  CAS  Google Scholar 

  17. Philips FS, Sternberg SS, Cronin AP, Vidal PM. Cyclophosphamide and urinary bladder toxicity. Cancer Res 1961;21:1577–89.

    PubMed  CAS  Google Scholar 

  18. Cox PJ. Cyclophosphamide cystitis and bladder cancer. A hypothesis. Eur J Cancer 1979;15(8):1071–2.

    PubMed  CAS  Google Scholar 

  19. Cox PJ. Cyclophosphamide cystitis—identification of acrolein as the causative agent. Biochem Pharmacol 1979;28(13):2045–9.

    Article  PubMed  CAS  Google Scholar 

  20. Korkmaz A, Topal T, Oter S. Pathophysiological aspects of cyclophosphamide and ifosfamide induced hemorrhagic cystitis; implication of reactive oxygen and nitrogen species as well as PARP activation. Cell Biol Toxicol 2007.

    Google Scholar 

  21. Bryant BM, Jarman M, Ford HT, Smith IE. Prevention of isophosphamide-induced urothelial toxicity with 2-mercaptoethane sulphonate sodium (mesnum) in patients with advanced carcinoma. Lancet 1980;2(8196):657–9.

    Article  PubMed  CAS  Google Scholar 

  22. Hoffman R. Pharmacology and molecular mechanisms of antineoplastic agents for hematologic malignancies. In: Hoffman R, et al. Hematology: Basic Principles and Practice. 4th ed Churchill Livingstone; 2005.

    Google Scholar 

  23. Shepherd JD, Pringle LE, Barnett MJ, Klingemann HG, Reece DE, Phillips GL. Mesna versus hyperhydration for the prevention of cyclophosphamide-induced hemorrhagic cystitis in bone marrow transplantation. J Clin Oncol 1991;9(11):2016–20.

    PubMed  CAS  Google Scholar 

  24. Dean RJ, Lytton B. Urologic complications of pelvic irradiation. J Urol 1978;119(1):64–7.

    PubMed  CAS  Google Scholar 

  25. Schoenrock GJ, Cianci P. Treatment of radiation cystitis with hyperbaric oxygen. Urology 1986;27(3):271–2.

    Article  PubMed  CAS  Google Scholar 

  26. Andriole GL, Brickman C, Lack EE, et al. Danazol-induced cystitis: An undescribed source of hematuria in patients with hereditary angioneurotic edema. J Urol 1986;135(1):44–6.

    PubMed  CAS  Google Scholar 

  27. Gheyi SK, Robertson A, Atkinson PM. Severe interstitial cystitis caused by tiaprofenic acid. J R Soc Med 1999;92(1):17.

    PubMed  CAS  Google Scholar 

  28. Schou J, Jensen HL, Frimodt-Moller C. Interstitial cystitis provoked by tiaprofenic acid. Scand J Urol Nephrol 1999;33(6):411–2.

    Article  PubMed  CAS  Google Scholar 

  29. Sabichi AL, Lippman SM. COX-2 inhibitors and other NSAIDs in bladder and prostate cancer. Prog Exp Tumor Res 2003;37:163–78.

    PubMed  CAS  Google Scholar 

  30. Brown JR, DuBois RN. COX-2: A molecular target for colorectal cancer prevention. J Clin Oncol 2005;23(12):2840–55.

    Article  PubMed  CAS  Google Scholar 

  31. Williams JL, Nath N, Chen J, et al. Growth inhibition of human colon cancer cells by nitric oxide (NO)-donating aspirin is associated with cyclooxygenase-2 induction and beta-catenin/T-cell factor signaling, nuclear factor-kappaB, and NO synthase 2 inhibition: implications for chemoprevention. Cancer Res 2003;63(22):7613–8.

    PubMed  CAS  Google Scholar 

  32. Pode D, Perlberg S, Steiner D. Busulfan-induced hemorrhagic cystitis. J Urol 1983;130(2):347–8.

    PubMed  CAS  Google Scholar 

  33. Treible DP, Skinner D, Kasimain D, Friedman NB, Kern WH. Intractable bladder hemorrhage requiring cystectomy after use of intravesical thiotepa. Urology 1987;30(6):568–70.

    Article  PubMed  CAS  Google Scholar 

  34. Nellans RE, Ellis LR, Kenny GM. Ether cystitis. JAMA 1985;254(4):530.

    Article  PubMed  CAS  Google Scholar 

  35. Walsh C, Walsh A. Haemorrhagic cystitis due to gentian violet. Br Med J (Clin Res Ed) 1986;293(6549):732.

    CAS  Google Scholar 

  36. Pliskin MJ, Dresner ML. Inadvertent urethral insertion of a contraceptive suppository. J Urol 1988;139(5):1049–50.

    PubMed  CAS  Google Scholar 

  37. Ross RR, Jr., Conway GF. Hemorrhagic cystitis following accidental overdose of methenamine mandelate. Am J Dis Child 1970;119(1):86–7.

    PubMed  Google Scholar 

  38. Osorio AV, Simckes AM, Hellerstein S. Hemorrhagic cystitis caused by acetic acid instillation. J Urol 1996;155(2):685.

    Article  PubMed  CAS  Google Scholar 

  39. Folland DS, Kimbrough RD, Cline RE, Swiggart RC, Schaffner W. Acute hemorrhagic cystitis. Industrial exposure to the pesticide chlordimeform. JAMA 1978;239(11):1052–5.

    Article  PubMed  CAS  Google Scholar 

  40. Nurmi MJ, Ekfors TO, Puntala PV. Secondary amyloidosis of the bladder: a cause of massive hematuria. J Urol 1987;138(1):44–5.

    PubMed  CAS  Google Scholar 

  41. Montie JE, Stewart BH. Massive bladder hemorrhage after cystoscopy in a patient with secondary systemic amyloidosis. J Urol 1973;109(1):49–50.

    PubMed  CAS  Google Scholar 

  42. Frayha RA, Kuleilat M, Mufarrij A, Mufarrij W. Hemorrhagic cystitis and sicca syndrome secondary to amyloidosis in rheumatoid arthritis. J Rheumatol 1985;12(2):378–9.

    PubMed  CAS  Google Scholar 

  43. Hatakeyama N, Suzuki N, Kudoh T, Hori T, Mizue N, Tsutsumi H. Successful cidofovir treatment of adenovirus-associated hemorrhagic cystitis and renal dysfunction after allogenic bone marrow transplant. Pediatr Infect Dis J 2003;22(10):928–9.

    Article  PubMed  Google Scholar 

  44. Walden O, Hartel C, Doehn C, Jocham D. [Intravesical cidofovir – instillation therapy for polyomavirus-associated hemorrhagic cystitis after bone marrow transplantation.]. Urologe A 2006;46:535–537.

    Google Scholar 

  45. Kelly JD, Young MR, Johnston SR, Keane PF. Clinical response to an oral prostaglandin analogue in patients with interstitial cystitis. Eur Urol 1998;34(1):53–6.

    Article  PubMed  CAS  Google Scholar 

  46. Lartigau E, Mathieu D. Hyperbaric oxygen therapy in the treatment of radio-induced lesions in normal tissues, consensus conference. In: European Society for Therapeutic Radiology and Oncology and the European Committee for Hyperbaric Medicine. Lisbon, Portugal; 2001.

    Google Scholar 

  47. Pasquier D, Hoelscher T, Schmutz J, et al. Hyperbaric oxygen therapy in the treatment of radio-induced lesions in normal tissues: A literature review. Radiother Oncol 2004;72(1):1–13.

    Article  PubMed  CAS  Google Scholar 

  48. Chong KT, Hampson NB, Corman JM. Early hyperbaric oxygen therapy improves outcome for radiation-induced hemorrhagic cystitis. Urology 2005;65(4):649–53.

    Article  PubMed  Google Scholar 

  49. Capelli-Schellpfeffer M, Gerber GS. The use of hyperbaric oxygen in urology. J Urol 1999;162(3 Pt 1):647–54.

    Article  PubMed  CAS  Google Scholar 

  50. Neheman A, Nativ O, Moskovitz B, Melamed Y, Stein A. Hyperbaric oxygen therapy for radiation-induced haemorrhagic cystitis. BJU Int 2005;96(1):107–9.

    Article  PubMed  Google Scholar 

  51. Bevers RF, Bakker DJ, Kurth KH. Hyperbaric oxygen treatment for haemorrhagic radiation cystitis. Lancet 1995;346(8978):803–5.

    Article  PubMed  CAS  Google Scholar 

  52. Ostroff EB, Chenault OW, Jr. Alum irrigation for the control of massive bladder hemorrhage. J Urol 1982;128(5):929–30.

    PubMed  CAS  Google Scholar 

  53. Kennedy C, Snell ME, Witherow RO. Use of alum to control intractable vesical haemorrhage. Br J Urol 1984;56(6):673–5.

    PubMed  CAS  Google Scholar 

  54. Mukamel E, Lupu A, deKernion JB. Alum irrigation for severe bladder hemorrhage. J Urol 1986;135(4):784–5.

    PubMed  CAS  Google Scholar 

  55. Kavoussi LR, Gelstein LD, Andriole GL. Encephalopathy and an elevated serum aluminum level in a patient receiving intravesical alum irrigation for severe urinary hemorrhage. J Urol 1986;136(3):665–7.

    PubMed  CAS  Google Scholar 

  56. Modi KB, Paterson PJ. Alum irrigation in massive bladder hemorrhage in severe renal failure. Am J Kidney Dis 1988;12(3):233–5.

    PubMed  CAS  Google Scholar 

  57. Shoskes DA, Radzinski CA, Struthers NW, Honey RJ. Aluminum toxicity and death following intravesical alum irrigation in a patient with renal impairment. J Urol 1992;147(3):697–9.

    PubMed  CAS  Google Scholar 

  58. Kumar AP, Wrenn EL, Jr., Jayalakshmamma B, Conrad L, Quinn P, Cox C. Silver nitrate irrigation to control bladder hemorrhage in children receiving cancer therapy. J Urol 1976;116(1):85–6.

    PubMed  CAS  Google Scholar 

  59. West NJ. Prevention and treatment of hemorrhagic cystitis. Pharmacotherapy 1997;17(4):696–706.

    PubMed  CAS  Google Scholar 

  60. Levine LA, Jarrard DF. Treatment of cyclophosphamide-induced hemorrhagic cystitis with intravesical carboprost tromethamine. J Urol 1993;149(4):719–23.

    PubMed  CAS  Google Scholar 

  61. Liu YK, Kosfeld RE, Marcum SG. Treatment of uraemic bleeding with conjugated oestrogen. Lancet 1984;2(8408):887–90.

    Article  PubMed  CAS  Google Scholar 

  62. Liu YK, Harty JI, Steinbock GS, Holt HA, Jr., Goldstein DH, Amin M. Treatment of radiation or cyclophosphamide induced hemorrhagic cystitis using conjugated estrogen. J Urol 1990;144(1):41–3.

    PubMed  Google Scholar 

  63. Miller J, Burfield GD, Moretti KL. Oral conjugated estrogen therapy for treatment of hemorrhagic cystitis. J Urol 1994;151(5):1348–50.

    PubMed  CAS  Google Scholar 

  64. Sandhu SS, Goldstraw M, Woodhouse CR. The management of haemorrhagic cystitis with sodium pentosan polysulphate. BJU Int 2004;94(6):845–7.

    Article  PubMed  Google Scholar 

  65. Parsons CL. Successful management of radiation cystitis with sodium pentosanpolysulfate. J Urol 1986;136(4):813–4.

    PubMed  CAS  Google Scholar 

  66. Choong SK, Walkden M, Kirby R. The management of intractable haematuria. BJU Int 2000;86(9):951–9.

    Article  PubMed  CAS  Google Scholar 

  67. Hald T, Mygind T. Control of life-threatening vesical hemorrhage by unilateral hypogastric artery muscle embolization. J Urol 1974;112(1):60–3.

    PubMed  CAS  Google Scholar 

  68. Braf ZF, Koontz WW, Jr. Gangrene of bladder. Complication of hypogastric artery embolization. Urology 1977;9(6):670–1.

    Article  PubMed  CAS  Google Scholar 

  69. Carmignani G, Belgrano E, Puppo P, Cichero A, Giuliani L. Transcatheter embilization of the hypogastric arteries in cases of bladder hemorrhage from advanced pelvic cancers: followup in 9 cases. J Urol 1980;124(2):196–200.

    PubMed  CAS  Google Scholar 

  70. Zagoria RJ, Hodge RG, Dyer RB, Routh WD. Percutaneous nephrostomy for treatment of intractable hemorrhagic cystitis. J Urol 1993;149(6):1449–51.

    PubMed  CAS  Google Scholar 

Download references

Authors
  1. S. E. McAchran MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Raymond R. Rackley MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Glickman Urologic and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA

    Jeannette M. Potts MD

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Humana Press

About this chapter

Cite this chapter

McAchran, S.E., Rackley, R.R. (2008). Hemorrhagic and Radiation Cystitis. In: Potts, J.M. (eds) Genitourinary Pain And Inflammation. Current Clinical Urology. Humana Press. https://doi.org/10.1007/978-1-60327-126-4_24

Download citation

  • DOI: https://doi.org/10.1007/978-1-60327-126-4_24

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-816-4

  • Online ISBN: 978-1-60327-126-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation