Page 7 - Diagnosis and management of radiation-induced hemorrhagic cystitis

Persistent or recurrent clinically

significant hematuria

Intravesical agents:

• Irrigation with alum is a practical and easily applied treatment for radiation-

induced hemorrhagic cystitis with a comparatively acute onset of action that is

generally well tolerated. Special caution should be used in patients with poor
renal function (Grade 3C).

• Intravesical therapy with hyaluronic acid may improve symptoms of RHC, and

may provide further benefit in those with significant LUTS. Its slow onset of

action and lack of research in severe hematuria may limit its usefulness in the

acute or in-patient setting (Grade 3C).
• Several [other] intravesical options have been trialed in limited case series, but

require replication, etiology-specific assessment, or comparative data before
they can be formally included as recommendations (Grade 3D).