An inflammation of the bladder, hemorrhagic cystitis is a condition in which the patient experiences irritable bowel syndrome and bladder pain. In other words, it is the onset of hematuria or blood in the urine.
The condition is commonly caused by chemotherapy medications and drugs prescribed for leukemia, lymphoma, and blood and marrow cancers. The breaking down of these medications in the body produces a byproduct, known as acrolein. The byproduct can irritate tissues when it travels to the bladder, causing ulcers and cystitis that can cause serious bleeding.
The condition may also be caused by certain viruses, like JC virus and adenovirus. People with compromised immune systems are at a higher risk, especially those recovering from stem cell transplant and leukemia.
Radiation therapy can also cause irritation of the bladder, leading to hemorrhagic cystitis.
Hemorrhagic Cystitis Symptoms
The symptoms of hemorrhagic cystitis include:
- Extreme abdominal discomfort
- Blood in the urine
- Loss of bladder control
- A feeling of burning while passing urine
- Urgent need to empty bladder/urinary urgency
- Feeling that you are not able to empty the bladder
- Urinary frequency
- Involuntary loss of urine
- Painful urination
- Vague abdominal pain
- Bladder infection
While bleeding is the most common symptom of hemorrhagic cystitis, some patients may experience atrophy of the bladder, bladder wall scarring, and severe systemic infection.
Oncology patients are at a great risk for developing hemorrhagic cystitis. Other risks include:
- Pelvic radiation therapy
- Chemotherapy medications
- Radiation therapy
- Frequent use of antibiotics
- Chemicals, such as insecticides, dyes, recreational drugs
- Urinary tract infections
- Low platelet count
- Weakened immune system
- Bone marrow transplant
Treatment of Hemorrhagic Cystitis
The infected person can suffer from severe blood loss. Bladder ulcers provide entry points for bacteria to enter your bloodstream, which risks causing permanent scarring of the bladder lining. This could cause bladder constriction or blockage of the urinary tract. Prompt treatment becomes critically important in such a condition.
- Platelet transfusion to stop bleeding
- Pain control medications
- Blood transfusions for patients who have experienced severe loss of blood
- Saline therapy for the bladder to prevent clots
- Antibiotic/antiviral therapy for infectious cystitis
- Discontinuation of medications responsible for bladder problems
For patients undergoing chemotherapy, the best way to prevent hemorrhagic cystitis is to drink plenty of intravenous fluids so that chemo medications quickly pass through the bladder. Taking chemotherapy early in the day will give your body an opportunity to clear it from the bladder. Diuretics are also administered to clear chemo from the body before it can cause ulceration.