Endovascular management of radiation-induced hemorrhagic cystitis

Abstract

Radiation-induced hemorrhagic cystitis (HC) is an unpleasant and sometimes life-threatening complication confronted while treating pelvic malignancies. A wide array of treatment modalities such as bladder irrigation, fulguration, hyperbaric oxygen therapy, and surgical methods has been proposed to treat hematuria, but there is no consensus on the optimal therapeutic strategy for the same. Reported here is a successful superselective embolization of the bilateral vesical arteries in a patient with refractory radiation-induced HC. This technique proved to be effective in controlling intractable hemorrhage and can be considered an option for the treatment of HC not amenable to conventional techniques.

Chronic Inflammation and Radiation-Induced Cystitis: Molecular Background and Therapeutic Perspectives

“…The main adverse events were Brown–Sequard’s syndrome, bladder necrosis, and gluteal paresis or skin necrosis. Thanks to improved techniques, the incidence of adverse events has decreased from 65% to 9–31% [ 36 , 37 ]. The follow-up of these studies is brief.…”