Open Access

REVIEW

Hemorrhagic cystitis: a review of the literature and treatment options

Maria J. D’Amico, Halle Foss, Alex Uhr, Benjamin Rudnick, Edward Kloniecke, Leonard G. Gomella

Department of Urology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Address correspondence to Dr. Maria J. D’Amico, Department of Urology, Thomas Jefferson University Hospital, 1025 Walnut St, Suite 1100, Philadelphia, PA 19107 USA

Canadian Journal of Urology 2022, 29(5), 11276-11283.

Abstract

Introduction: Hemorrhagic cystitis (HC) is a morbid condition for patients and can be challenging for urologists to manage. There are many potential contributing etiologies and the severity of bleeding can be variable. It is important to consider each clinical scenario when formulating management strategies in order to provide the highest quality of care to patients. We provide a review of the literature including diagnosis and treatment options.
Materials and methods: We performed a literature search on PubMed using the following keywords: hemorrhagic cystitis, cystitis, gross hematuria, intractable hematuria. We considered all available published articles with no specific inclusion or exclusion criteria for the purposes of this review.
Results: We reviewed a total of 41 articles and identified a broad differential diagnosis for intractable hemorrhagic cystitis including infection, chemical exposure, malignancy, nephropathy, trauma, radiation therapy, and idiopathic etiology. Depending on the severity of bleeding, many treatments have been described. These range from conservative strategies (bladder fulguration and continuous irrigation) to more extreme and morbid therapies (intravesical instillations, embolization, and urinary diversion).
Conclusion: Hemorrhagic cystitis is a relatively common and can be a difficult condition to manage for urologists. It is important to understand the etiology and available treatments options in order to best treat our patients. We provide a comprehensive and thorough review of the literature and propose a stepwise treatment approach.

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Keywords

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