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Current management of radiation cystitis: a review and practical guide to clinical management
Author(s) -
Pascoe Claire,
Duncan Catriona,
Lamb Benjamin W.,
Davis Niall F.,
Lynch Thomas H.,
Murphy Declan G.,
Lawrentschuk Nathan
Publication year - 2019
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.14516
Subject(s) - medicine , narrative review , intensive care medicine , radiation therapy , surgery
Haemorrhage is a frequent complication of radiation cystitis leading to emergency presentations in patients with prior pelvic radiation therapy. Standard initial patient management strategies involve resuscitation, bladder washout with clot evacuation and continuous bladder irrigation. Beyond this, definitive surgical treatment is associated with significant morbidity and mortality. Alternative less invasive management options for non‐emergent haemorrhagic cystitis include systemic medical therapies, hyperbaric oxygen ( HBO ), intravesical therapies and laser ablation. However, evidence to support and compare treatment for haemorrhagic radiation cystitis is limited. Methods Herein, a literature search pertaining to the current management of haemorrhagic cystitis was conducted. Results In total, 23 studies were included in this review with 2 studies reviewing systemic therapy, 7 studies evaluating HBO therapy, 10 studies investigating a variety of intravesical therapies and the remaining 4 were relating to ablative therapies. Across these studies, the patient groups were heterogenous with small numbers and variable follow up periods. Conclusion With evaluation of existing literature, this narrative review also provides a stepwise clinical algorithm to aid the urologist in treating patients presenting with complications associated with radiation cystitis.