Successful Treatment of Chemotherapy Induced Hemorrhagic Cystitis with Intravesical Application of A Specific Product in n Ambulatory Setting

Author(s): Elisaveta Gerova, Jorg Humburg

Background and Aim: Hemorrhagic cystitis (HC) is an inflammation of the urinary bladder defined by signs of urinary bladder irritation and hematuria. It is thought that damage to the Glycosaminoglycan- (GAG) layer, which coats the uroepithelium and provides the initial barrier for physiological protection, may be the first step in its development. The disease can be triggered by chemotherapeutic drugs exposure and radiation therapy. The incidence rate of HC is predicted to rise substantially in the future as more aggressive treatments of cancer are implemented.

Case Presentation: A 53-year old female patient presented with persistent dysuria, frequent voiding and nocturia. At the time the patient received adjuvant chemotherapy for her breast cancer.

The patient presented with late-onset hemorrhagic cystitis after completing four cycles of chemotherapy. We treated her with intravesical instillations of hyaluronic acid and chondroitin sulphate in order to substitute the GAG layer.

The report’s primary aim is to present the significant effect of an intravesical application of a GAG layersubstitution product.

In our case report, we outline the indications as well as procedural steps of our approach and compare the results with those of other therapies and troubleshooting recommendations.

The treatment was held in an ambulatory setting, making it both cost-effective and lifestyle-friendly for our patient. To the best of our knowledge, the treatment as described has not yet been used in chemotherapy-induced HC.

Conclusions: This is the first report showing complete regression of haemorrhagic cystitis after inravesical application of a specific product. Prospective studies should evaluate if the treatment effect is reproducible and if this approach could be a useful profilactic measure as well as a sucessful treatment for chemotherapy-induced haemorrhagic cystitis.

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