Open AccessTreatment of Massive Bladder Hemorrhage of Cancerous Etiology Using Selective Embolization
Author(s) -
Tomasz Ząbkowski,
Piotr Piasecki,
Lubomir Bodnar,
Tomasz Syryło,
Henryk Zieliński,
Krzysztof Brzozowski,
Piotr Zięcina
Publication year - 2018
Publication title -
journal of global oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.002
H-Index - 17
ISSN - 2378-9506
DOI - 10.1200/jgo.18.55000
Subject(s) - medicine , etiology , embolization , blood transfusion , hematocrit , bladder cancer , surgery , cancer
Background: Massive and intractable bladder hemorrhage of cancerous etiology are very dangerous and directly life-threatening. Its treatment is very difficult and complicated because of the severity of bladder tumor and the general poor condition of the patient which does not enable a radical surgical treatment. Aim: To evaluate the efficiency of the treatment of massive bladder hemorrhage of cancerous etiology using internal iliac artery selective embolization of anterior division. Methods: From January 2006 through June 2015, 23 patients (17 male and 6 female) were admitted to Urology Department as a matter of urgency because of massive bladder hemorrhage of cancerous etiology secondary to muscle-invasive bladder cancer (MIBC) - 14 patients, rectal cancer (RC) with invading bladder - 2 patients, bowel cancer with invading bladder - 2 patients, prostate cancer (PC) with invading bladder - 3 patients and cervical cancer with invading bladder - 2 patients ( Fig 1 ). The mean age of patients was 63.5 (range 37-80). In all patients, internal iliac artery selective embolization of anterior division was performed. The baseline mean hematocrit level during admission of patients to hospital was 23%, after embolization - 27.5%. In 14 patients it was necessary a mean of 6 transfusion units of packed red blood cells (PRBCs), range 2-16 transfusion units of PRBCs. 6 patients also required a mean of 8 transfusion units of fresh frozen plasma (FFP), range 2-27 transfusion units of FFP. Results: In 20 (86.96%) patients, therapeutic success was achieved after the first procedure. In 3 (13.04%) patients who developed hematuria after 12-38 days from the first endovascular procedure, the next successful embolization was performed bilaterally. It was not developed any major complications after embolization. Conclusion: Embolization of internal iliac artery is considered as a highly effective and minimally invasive method in case of massive bladder hemorrhage of cancerous etiology.[Figure: see text]