PELVIC CANCER-INDUCED HEMMORHAGIC CYSTISIS

1. PELVIC CANCER-INDUCED HEMORRHAGIC CYSTISIS Hemorrhagic cystitis or hemorrhagic cystitis is an inflammation of the bladder defined by lower urinary tract symptoms that include dysuria, hematuria, and hemorrhage. The disease can occur as a complication of cyclophosphamide, ifosfamide, and radiation therapy. In addition to hemorrhagic cystitis, temporary hematuria can also be seen in bladder infections or in children as a result of viral infection. Unfortunately, mesna is ineffective as a treatment once hemorrhagic cystitis has developed. Although rare, once a case of radiation-induced hemorrhagic cystitis is diagnosed there is no empirically-proven treatments to heal this type of condition, which can severely degrade a patient's quality of life and might possibly lead to kidney failure with risk of death. Viral hemorrhagic cystitis in children generally spontaneously resolves within a few days The first step in the treatment of Hemmorhagic Cystisis should be directed toward clot evacuation. Bladder outlet obstruction from clots can lead to urosepsis, bladder rupture, and kidney failure. Clot evacuation can be performed by placing a wide-lumen bladder catheter at the bedside. The bladder can be irrigated with water or sodium chloride solution. The use of water is preferable because water can help with clot lysis. Care must be taken to not over- distend the bladder and cause a perforation. Hyperbaric oxygen (HBO2) therapy has been proven to be effective in treating radiation-induced hemorrhagic cystitis. KEY COMPANIES ●Novartis ●Regeneron Pharma ●Opthea Ltd ●Kodiak Sciences ●And many others. KEY THERAPIES ●Mesenchymal Stromal Cell (MSC) injections ●Ciprofloxacin ● Tiaprofenic Acid