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Cystitis

Hemorrhagic cystitis

Author: Monika Roychowdhury, M.D.

Last author update: 1 May 2015

Last staff update: 1 November 2021

Copyright: 2003-2024, PathologyOutlines.com, Inc.

PubMed Search: hemorrhagic cystitis

Table of Contents

Cite this page: Roychowdhury M. Hemorrhagic cystitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/bladderhemorrhagiccystitis.html. Accessed December 26th, 2024.

Definition / general

Clinical syndrome of gross hematuria, often with irritative bladder symptoms

Etiology

Due to drug treatment (cyclophosphamide, methotrexate, ifosphamide), radiation therapy (eMedicine: Hemorrhagic Cystitis [Accessed 11 July 2018]), viral infection (adenovirus, herpes simplex virus, CMV, BK virus)
Post allogeneic hematopoietic stem cell transplantation (Chin Med J (Engl) 2008;121:1766)
Occurs in 10% of pediatric bone marrow transplants (J Pediatr Urol 2009;5:254)

Clinical features

Irritative voiding symptoms, gross hematuria

Case reports

8 year old with BK virus associated hemorrhagic cystitis presenting as mural nodules (Pediatr Radiol 2010;40:1430)
47 year old man with malaise and recent UTI, with voided urine specimen (Case of the Week #353)
49 year old man with symptoms after receiving penicillin for endocarditis (Intern Med 2009;48:1667)
70 year old man with hemorrhagic cystitis due to melphalan (Case Rep Med 2010;2010:569138)

Treatment

Clot evacuation and hydration, bladder irrigation with saline or alkalinized saline, intravesical instillation of aluminium hydroxide / magnesium hydroxide
More aggressive therapies include transurethral coagulation of bladder, fixation with silver nitrate and formalin, embolization of internal iliac arteries or their branches to the bladder; rarely requires cystectomy

Clinical images

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