膀胱內玻尿酸灌注於放射治療後出血性膀胱之治療經驗
鍾尚融1、賴昱維1,2、薛又仁1,2、蕭毅君1、黃建榮1、邱文祥1,2
台北市立聯合醫院仁愛院區泌尿科、國立陽明大學醫學院醫學系泌尿學科
Intravesical hyaluronic acid instillation in the treatment of radiation-induced hemorrhagic cystitis in Taipei city hospital experience
Shang-Rong Zhong1,Yu-Wei Lai1,2, Thomas Y. Hsueh1,2, Yi-Jiun Hsiao1, Andy C. Huang1,Allen W. Chiu1,2
1Divisions of Urology, Department of Surgery, Taipei City Hospital, renai-branch, Taipei, Taiwan
2Department of Urology, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Purpose: Radiation-induced hemorrhagic cystitis is a complex clinical scenario requiring both medical and surgical treatments. We evaluated the efficacy of intravesical hyaluronic acid instillation for the treatment of radiation-induced hemorrhagic cystits in Taipei city hospital.
Materials and Methods: A total of 6 patients suffering from hemorrhagic cystitis after radiation therapy undergone intravesical hyaluronic acid treatment from 2016 to 2018 were identified retrospectively. All patients had active bleeding along with blood clot tamponade in the bladder via cystoscope examination and received endoscopic coagulation subsequently. 6 to 8 doses of intravesical hyaluronic acid instillation were performed with an interval of 1 to 4 weeks. Outpatient clinic follow-up were conducted in all patients while new episodes of hemorrhagic cystitis were recorded if present.
Results: The mean age of the patients are 72.8 years old and the median follow up period was months. There was no new episode of gross hematuria requiring cystoscopic intervention after the treatment till 2019/03. Improvement in urinary frequency and the visual analogue pain scale with regard to the pelvic pain were found in all patients.
Conclusions: Intravesical hyaluronic acid instillation provides promising clinical response for radiation-induced hemorrhagic cystitis and improvement in lower urinary tract symptoms in our patients.