Category: Other, Miscellaneous
Introduction & Objective : 10% patients receiving radiotherapy for various pelvic malignancies may develop hemorrhagic radiation cystitis (HRC).Argon plasma coagulation (APC) is an established treatment of hemorrhagic radiation proctitis. We present six patients managed with APC for HRC.
Methods : Bladder biopsies taken to rule out malignancy .CO2 gas used as a clear medium to distend the bladder .Fluid/urine aspirated intermittently via cystoscope as the bladder base needs to be visualised to apply APC .Head low and suprapubic pressure may help target areas to be accessible for APC application .Procedure time was 45 minutes to1.5 hours .3 way urethral catheter with irrigation postoperatively
Results : All patients except one underwent APC cystodiathermy once. One patient had it twice .Four had no recurrence of hematuria . two had recurrence which required further alum instillation. .All patients remained with an intact functional bladder on follow up
Conclusions : We present minimally invasive management of HRC allowing reduced morbidity and early patient discharge with an intact functional bladder.
Nikhil Kale– Registrar, Dept of Urology, North Middlesex University Hospital, London, England, United Kingdom
Yogit Wagh– London, England, United Kingdom
Harshawardhan Godbole– Consultant Urologist, North Middlesex University Hospital NHS Trust, London, England, United Kingdom
Dept of Urology, North Middlesex University Hospital
London, England, United Kingdom