Management of chemotherapy- or radiation therapy-induced hemorrhagic cystitis

* For most patients, the diagnostic evaluation to exclude other etiologies should be initiated concurrently with treatment and should include cystoscopy, urine cytology, and upper urinary tract imaging.

¶ Mild hemorrhagic cystitis includes those with one of the following presentations:

• Microscopic hematuria
• Minimal increase in frequency, urgency, dysuria, or nocturia
• New onset of urinary incontinence
• Gross hematuria without clots, and with adequate bladder emptying and only lower tract urinary symptoms

Δ Where available, hyperbaric oxygen is an option for relatively stable patients with radiation therapy-induced hemorrhagic cystitis.