Page 8 - Diagnosis and management of radiation-induced hemorrhagic cystitis
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Persistent or recurrent clinically
significant hematuria
Systemic agents:
• Multiple studies have demonstrated that hyperbaric oxygen therapy is safe and effective
and should be considered an early treatment option for RHC in patients who have failed
cystoscopy and fulguration. Due to significant resource and expertise requirements, its
use may be limited based on access and availability (Grade 3C).
• Several case series have shown a potential reduction of hematuria with treatment with
sodium pentosan polysulfate in patients with RHC. It is safe and generally well-tolerated,
although the slow onset of action may limit its usefulness in treatment of acute or severe
RHC (Grade 3C).
• Multiple [other] systemic agents have been used in small experimental situations for
treatment of radiation-induced hemorrhagic cystitis, until further studies are completed
no formal recommendations can be made regarding their use (Grade 3D).
