Bilateral percutaneous nephrostomy as treatment for severe hemorrhagic cystitis.
OBJECTIVE
To report a case of severe hemorrhagic cystitis successfully treated by bilateral percutaneous nephrostomy.


METHODS
The case of a 67-year-old female patient who had monosymptomatic gross hematuria with clots is reported.


RESULTS
Standard conservative treatments failed and the patient developed a clot-retention plugged bladder. Endoscopic evacuation and electrocoagulation of bleeding areas was unsuccessful. Due to persistent hematuria and development of renal failure and hemodynamic instability, bilateral percutaneous nephrostomy was performed. At 24 hours, hematuria ceased, patient recovered hemodynamic stability, and no additional blood transfusions were required.


CONCLUSIONS
Bilateral percutaneous nephrostomy may be a valuable option for the treatment of hemorrhagic cystitis when standard conservative measures have failed and as a prior step to performance of other more invasive procedures.
Pérez Fentes
Daniel A
DA
Urology and Anatomy Pathologic Department, Complejo Universitario de Santiago de Compostela, La Coruña, Spain. danielfentes@yahoo.es <danielfentes@yahoo.es>
Puñal Pereira
Ana
A
Lorenzo González
Pablo
P
García Freire
Camilo
C
Novás Castro
Serafín
S
Blanco Parra
Miguel
M
D000368:Aged; D003556:Cystitis / Q000601:surgery*; D005260:Female; D006470:Hemorrhage / Q000601:surgery*; D006801:Humans; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D012720:Severity of Illness Index