Continuous bladder irrigation prevents hemorrhagic cystitis after allogeneic hematopoietic cell transplantation

Pediatric hemorrhagic cystitis

“…The duration of late-onset HC as well as the duration of hospitalization were significantly shorter in the treatment groups (10 versus 18 days; 30 versus 40 days, respectively). Contrary to previously reported poor tolerance and increased UTIs with CBI [5], the authors noted that the preventive regimen was generally well-tolerated without a significant increase in UTIs [35]. While this study does report relatively high incidences of BMT-related HC in small cohorts, it is unique in showing that combined preventive strategies with CBI may be additionally beneficial.…”

“…More recently Hadjibabaie et al [35] performed a nonrandomized caseecontrol study that sought to investigate the role of CBI in addition to mesna, hydration, and alkalization in the prevention of HC after BMT. Forty adult patients underwent this combined regimen (CBI at 300 cc/h started 12 h before chemo and lasting 48 h after) versus 40 historical controls who did not receive CBI.…”

Prevention and management of BK‐virus associated haemorrhagic cystitis in children following haematopoietic stem cell transplantation – a systematic review and evidence‐based guidance for clinical management

“…The prophylactic insertion of a urinary catheter and continuous irrigation of the bladder with normal saline during the administration of high dose chemotherapy or conditioning regimens was common practice before the introduction of MESNA, with controversial results (Atkinson et al, 1991;Turkeri et al, 1995). A very recent, non-randomised clinical trial in the HSCT setting (Hadjibabaie et al, 2008) consisted of a prospective group of HSCT patients (n = 40) receiving continuous bladder irrgation with normal saline for 36 h during the conditioning regimen in addition to MESNA, hyperhydration and urine alkalinization, and a historical, retrospective control group (n = 40) of similar characteristics and management, but no preventative bladder irrigation. A significant reduction in incidence and duration of pre-engraftment HC was observed.…”

Target Inhibition of IL-1 Receptor Prevents Ifosfamide Induced Hemorrhagic Cystitis in Mice

“…3 In the clinical setting, the preventive use of mesna, hyperhydration and bladder irrigation drastically reduced the incidence of this disease. 3,4 However, bladder inflammation can still be identified through cystoscopy in approximately one-third of patients. 5 Together with the evidence that HC can also lead to long-term bladder dysfunction, 6 even the presence of a mild cystitis cannot be undervalued.…”