Suprapubic cystotomy as treatment for severe hemorrhagic cystitis after bone marrow transplantation.
We analyzed the success of suprapubic cystotomy in patients with severe hemorrhagic cystitis after bone marrow transplantation. Seventy-three out of 963 patients developed severe hemorrhagic cystitis which resulted in urinary tract obstruction after high-dose cytoreductive therapy. Eleven patients (15%) failed medical treatment and required emergency suprapubic cystotomy. Three of these patients died of other complications prior to resolution of HC. Of the remaining 8 patients who underwent surgery, 4 are alive. The mortality rate was significantly higher in patients who required surgery than in those who responded to medical therapy. Patients whose HC required surgery also had a greater transfusion requirement than those who responded to medical therapy. We conclude that surgical treatment of severe HC should be undertaken only after failure of medical therapy.
Baronciani
D
D
Divisione Ematologica e Centro Trapianto di Midollo Osseo di Muraglia, Pesaro, Italy.
Angelucci
E
E
Erer
B
B
Fabrizi
G
G
Galimberti
M
M
Giardini
C
C
Milella
D
D
Montesi
M
M
Polchi
P
P
Severini
A
A
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003556:Cystitis / Q000601:surgery*; D003559:Cystostomy; D005260:Female; D006470:Hemorrhage / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged