Abstract

A REVIEW ON CURRENT APPROACHES ON THE TREATMENT AND PREVENTIVE MEASURES FOR CHEMOTHERAPY AND RADIATION INDUCED HEMORRHAGIC CYSTITIS

Feba Stanly*, Rajani Yohannan, Dr. Varsha Dalal

ABSTRACT

Hemorrhagic Cystitis is a major complication which is most commonly induced by chemical drugs, radiational therapy, or exposing to chemicals. Despite recognizing HC as a significant complication of cancer therapy, there is currently a lack of guidelines available to optimally defined and manage HC. Hemorrhagic cystitis patients frequently have a history of radiation or chemical exposure. They are frequently inpatients or are well known to the services they provide. Hematuria is symptom of non-infectious hemorrhagic cystitis, which is characterized by bladder inflammation. Urgency, frequency dysuria and in certain cases abdominal discomfort are common symptoms of this illness. The presence or absence of clotted blood in the urine does not totally rule out an upper urinary tract etiology for hemorrhagic cystitis, but the presence of long, stringy clots does. Supra-pubic pain, urine frequency, and inability to empty the bladder due to clots are some of the symptoms. A systematic literature review was undertaken to evaluate the evidences regarding the preventive measures and options available in the management of this condition. The review also included evaluating the published data on predisposing risk factors for anti-cancer drugs induced HC. The standard initial patient management involves 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 treatment options for non-emergent hemorrhagic cystitis include systemic medical therapies, hyperbaric oxygen, intra-vesical therapies and laser ablation. With evaluation of existing literature, this narrative review evaluates the pre disposing factors, preventive and treatment options for HC.

Keywords: Haemorrhagic cystitis, radiation cystitis, chemotherapy induced HC, chemical cystitis.