Cystoscopic application of PuraStat® in the treatment of radiation-induced haemorrhagic cystitis.
Ann R Coll Surg Engl
; 2024 Feb 16.
Article
en En
| MEDLINE
| ID: mdl-38362741
ABSTRACT
The use of radiotherapy has increased in recent years, especially for pelvic neoplasms, and this can result in long-term complications such as recurrent haemorrhagic radiation cystitis (RHC). A 73-year-old male patient presented to a hospital emergency department multiple times with visible haematuria and clots leading to urinary clot retention; he was finally diagnosed with RHC. During the last presentation, the bladder was irrigated continuously with saline using a three-way catheter. During hospitalisation, a cystourethroscopy was performed for bladder evaluation and clot evacuation. Multiple bleeding ulcers were recognised on the bladder wall, biopsies were taken for histopathology, and the ulcers cauterised. Packed red blood cell transfusions were required, and sodium hyaluronate (CystiStat®) bladder instillations were tried. There was no clinical improvement following any of these interventions. In light of the patient's deteriorating condition, cystoscopic application of PuraStat® 3ml was administered, which led to remission of the urinary bleeding in the short term. We continue to monitor the effects in the medium and long term. Based on current data, PuraStat® haemostatic agent therapy may be considered for RHC, when traditional treatments are ineffective or infeasible, potentially eliminating the need for more aggressive therapy such as cystectomy.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
Ann R Coll Surg Engl
Año:
2024
Tipo del documento:
Article
País de afiliación:
Reino Unido