Page 9 - Diagnosis and management of radiation-induced hemorrhagic cystitis

Refractory and life-threatening

hematuria

Trans-arterial embolization:

• Trans-arterial embolization is a viable option for control of radiation-induced

hematuria in those whom less invasive methods have been unsuccessful.

Preference should be given to selective, or super-selective embolization when
available to lessen possible side effects (Grade 3C).

Formalin:

• Due to significant morbidity associated with the procedure, formalin

instillations should only be used in those who have failed less invasive

treatments. If treatment is necessary, all attempts should be made to prevent

reflux into the upper tracts and the patient needs careful monitoring for

potential side effects (Grade 3C).