The management of intractable haematuria

Choong, S.K.S.; Walkden, M.; Kirby, R.

doi:10.1046/j.1464-410x.2000.00900.x

Cited by 111 publications

(111 citation statements)

References 67 publications

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“…Radiotherapy and TURP are the most common procedures used. Other treatment options include intravesical fibrin-glue instillation, laser coagulation, percutaneous nephrostomy tube insertion, internal iliac artery embolization, surgical diversion and cystectomy [Choong et al 2000].…”

Section: Discussionmentioning

confidence: 99%

Is whole gland salvage cryotherapy effective as palliative treatment of haematuria in patients with locally advanced prostate cancer? Results of a preliminary case series

Magno

Mucciardi

Galı̀

et al. 2015

Therapeutic Advances in Urology

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Objectives: Locally advanced prostate cancer may cause several complications such as haematuria, bladder outlet obstruction, and renal failure due to the ureteral obstruction. Various treatments have been suggested, including radiotherapy, antifibrinolytics, bladder irrigation with alum solution, transurethral surgery and angioembolization, none of which have proven effectiveness. In the last years cryoablation has become a valid therapeutic option for prostate cancer. In our experience we used this 'new' technique as haemostatic therapy. Methods: We selected four patients with gross haematuria affected by locally advanced hormone refractory prostate cancer, who had already been treated with primary radiotherapy. We used third-generation cryotherapy: under ultrasonographic guidance, we inserted six cryoprobes, two in each of the vascular pedicles reaching at least −60°C, and three thermometers. We then induced two freeze-thaw cycles. Results: After the operation the haematuria stopped in all patients and at 9-month follow up we observed a mean of four red cells (range three to five) in the urinary sediment with no evidence of bacteriuria. Prostate volume, prostate-specific antigen and postmicturition residue were significantly reduced. Qmax improved significantly too. Conclusion: Our experience has given us good results with minimal intra-and postoperative complications. We think that haemostatic cryotherapy as a palliative approach for locally advanced prostate cancer could represent a valid treatment option and more consideration could be given to its use.

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Section: Discussionmentioning

confidence: 99%

Is whole gland salvage cryotherapy effective as palliative treatment of haematuria in patients with locally advanced prostate cancer? Results of a preliminary case series

Magno

Mucciardi

Galı̀

et al. 2015

Therapeutic Advances in Urology

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“…However, the accumulated experience is based on a limited number of patients. 15 Intravesical 1% alumin irrigation represents an effective and a rather well-tolerated treatment for patients with HC associated with bladder carcinoma and irradiation. However, the available data on the use of alumin for patients with post-transplant HC are limited.…”

Section: Discussionmentioning

confidence: 99%

Treatment of post-hematopoietic stem cell transplantation hemorrhagic cystitis with intravesicular sodium hyaluronate

Miodosky

Abdul-Hai

Tsirigotis

et al. 2006

Bone Marrow Transplant

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“…It acts as an astringent at the site of bleeding, causing a protein precipitation at the urothelial surface which leads to decreased capillary permeability, contraction of intercellular space, vasoconstriction and reduction in oedema and inflammation. It can result in formation of precipitant which may further block the catheter and can be avoided by increasing the flow rate (Choong et al, 2000). Kennedy et al prepared 1% solution of alum by dissolving 400 grams of potash of alum (McCarthy's) in 4 L of hot sterile water and 300 ml of this solution was added to 3 L of sterile normal saline through a sterilising filter to form irrigating alum solution (Kennedy et al, 1984).…”

Section: Alum Irrigationmentioning

confidence: 99%

“…Kavoussi LR has reported sever renal impairment, encephalopathy, metabolic acidosis and coagulopathy while receiving continuous intra-vesical alum irrigation for severe urinary haemorrhage (Kavoussi et al, 1986). Death has also been reported in extreme cases after continuous intra-vesical alum irrigation (Choong et al, 2000). Although alum irrigation is a safe, easy and low cost procedure, severe aluminium toxicity may occur in patients with renal impairment.…”

Section: Alum Irrigationmentioning

confidence: 99%

Radiation Induced Cystitis and Proctitis - Prediction, Assessment and Management

Mallick¹,

Madan²,

Julka³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Cystitis and proctitis are defined as inflammation of bladder and rectum respectively. Haemorrhagic cystitis is the most severe clinical manifestation of radiation and chemical cystitis. Radiation proctitis and cystitis are major complications following radiotherapy. Prevention of radiation-induced haemorrhagic cystitis has been investigated using various oral agents with minimal benefit. Bladder irrigation remains the most frequently adopted modality followed by intra-vesical instillation of alum or formalin. In intractable cases, surgical intervention is required in the form of diversion ureterostomy or cystectomy. Proctitis is more common in even low dose ranges but is self-limiting and improves on treatment interruption. However, treatment of radiation proctitis is broadly non-invasive or invasive. Non-invasive treatment consists of non-steroid anti-inflammatory drugs (NSAIDs), anti-oxidants, sucralfate, short chain fatty acids and hyperbaric oxygen. Invasive treatment consists of ablative procedures like formalin application, endoscopic YAG laser coagulation or argon plasma coagulation and surgery as a last resort.

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The management of intractable haematuria

Cited by 111 publications

References 67 publications

Is whole gland salvage cryotherapy effective as palliative treatment of haematuria in patients with locally advanced prostate cancer? Results of a preliminary case series

Is whole gland salvage cryotherapy effective as palliative treatment of haematuria in patients with locally advanced prostate cancer? Results of a preliminary case series

Treatment of post-hematopoietic stem cell transplantation hemorrhagic cystitis with intravesicular sodium hyaluronate

Radiation Induced Cystitis and Proctitis - Prediction, Assessment and Management

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