Severe Cystitis Induced by Cyclophosphamide

Abstract

Hemorrhagic cystitis secondary to cyclophosphamide (Cytoxan) administration commonly responds to cessation of therapy and hydration. Occasionally, however, hemorrhage may be unresponsive to these measures. Fourteen patients with severe bladder hemorrhage described in the literature and two reported herein failed to respond and required surgical intervention. Review of the surgical procedures employed indicates that supravesical urinary diversion was promptly and consistently effective in controlling life-threatening bladder hemorrhage secondary to cyclophosphamide therapy. The pathophysiology of the disease underlies the rationale of surgical management.