Management of radiation cystitis

dc.contributor.authorSmit, Shaun G.en_ZA
dc.contributor.authorHeyns, Chris F.en_ZA
dc.date.accessioned2011-05-15T16:17:25Z
dc.date.available2011-05-15T16:17:25Z
dc.date.issued2010-04
dc.descriptionThe original publication is available http://www.nature.com/nrurol/journal/v7/n4/full/nrurol.2010.23.htmlen_ZA
dc.description.abstractAcute radiation cystitis occurs during or soon after radiation treatment. It is usually self-limiting, and is generally managed conservatively. Late radiation cystitis, on the other hand, can develop from 6 months to 20 years after radiation therapy. The main presenting symptom is hematuria, which may vary from mild to severe, life-threatening hemorrhage. Initial management includes intravenous fluid replacement, blood transfusion if indicated and transurethral catheterization with bladder washout and irrigation. Oral or parenteral agents that can be used to control hematuria include conjugated estrogens, pentosan polysulfate or WF10. Cystoscopy with laser fulguration or electrocoagulation of bleeding points is sometimes effective. Injection of botulinum toxin A in the bladder wall may relieve irritative bladder symptoms. Intravesical instillation of aluminum, placental extract, prostaglandins or formalin can also be effective. More-aggressive treatment options include selective embolization or ligation of the internal iliac arteries. Surgical options include urinary diversion by percutaneous nephrostomy or intestinal conduit, with or without cystectomy. Hyperbaric oxygen therapy (HBOT) involves the administration of 100% oxygen at higher than atmospheric pressure. The reported success rate of HBOT for radiation cystitis varies from 60% to 92%. An important multicenter, double-blind, randomized, sham-controlled trial to evaluate the effectiveness of HBOT for refractory radiation cystitis is currently being conducted. © 2010 Macmillan Publishers Limited. All rights reserved.en_ZA
dc.format.extent15 p. : ill.
dc.identifier.citationSmit, S. G. & Heyns, C. F. 2010. Management of radiation cystitis. Nature Reviews Urology, 7(4):206-214, doi:10.1038/nrurol.2010.23.en_ZA
dc.identifier.issn1759-4820 (online)
dc.identifier.issn1759-4812 (print)
dc.identifier.otherdoi:10.1038/nrurol.2010.23
dc.identifier.urihttp://hdl.handle.net/10019.1/14211
dc.language.isoen_ZA
dc.publisherNature Publishing Groupen_ZA
dc.rights.holderAuthors retain copyrihten_ZA
dc.subjectCystitis -- Treatmenten_ZA
dc.subjectRadiation injuriesen_ZA
dc.titleManagement of radiation cystitisen_ZA
dc.typeArticleen_ZA
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