title: A case of severe hemorrhagic cystitis caused by melphalan with successful bladder preservation by ligation of bilateral internal iliac arteries.
abstract: Hemorrhagic cystitis is a disorder which causes bleeding from diffusely inflammatory bladder mucosa. Here we present a case of severe hemorrhagic cystitis caused by melphalan. A 70-year-old man with multiple myeloma was presented with suddenly commenced massive gross hematuria. During an attempt of transurethral coagulation of bladder mucosa, bladder perforation into peritoneal cavity was suspected, then open laparotomy was indicated. We isolated bilateral internal iliac arteries and ligated them in order to control continued bleeding. After that, bladder bleeding was suddenly diminished. Ligation of internal iliac arteries may be a choice in controlling massive bleeding from bladder with severe hemorrhagic cystitis when laparotomy was inevitable.
authors.affiliation: Department of Urology, Kanto Rosai Hospital, 1-1 Kizukisumiyoshi-cho, Nakahara-ku, Kawasaki 211-8510, Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Zaitsu
authors.forename: Koji
authors.initials: K
authors.lastname: Mikami
authors.forename: Yuta
authors.initials: Y
authors.lastname: Takeshima
authors.forename: Takashi
authors.initials: T
authors.lastname: Matsunaga
authors.forename: Naohiko
authors.initials: N
authors.lastname: Okamoto
authors.forename: Sadao
authors.initials: S
authors.lastname: Imao