Category: Other, Miscellaneous

VS4-3 - Argon Beam Gas Cystodiathermy : minimally invasive management of hemorrhagic radiation cystitis

Fri, Sep 21
2:00 PM - 4:00 PM

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 C. Kale

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