Treatment of Radiation Induced Hemorrhagic Cystitis: Angiographic Embolization of Hypogastric Arteries

Yoon, Jae Sik; Kim, Chun Il; Sohn, Cheol Ho

Abstract

PURPOSE: We assessed the long term efficacy and complications of angiographic embolization of hypogastric arteries in treating the intractable bladder hemorrhage induced by radiation.
MATERIALS AND METHODS
From January 1990 to December 1997, a total of 43 patients with radiation induced hemorrhagic cystitis were evaluated. Of 43 patients, 5 patients were treated by bilateral selective angiographic embolization of the anterior branches of the hypogastric arteries. The embolic material used in all patients was gelfoam.
RESULTS
Five patients with intractable bladder hemorrhage were treated by bilateral selective embolization of the anterior branches of the hypogastric arteries by gelfoam and successful in completely stopping or considerably decreasing intractable bladder hemorrhage in all patients. The average number of treatments was 1.6(range 1 to 2). There was no significant sequelae ocurred as a consequence of simultaneous bilateral occlusion of the hypogastric arteries.
CONCLUSIONS
Radiation induced hemorrhagic cystitis that do not respond to irrigations with chemical cauterizing agents or transurethral fulguration of bleeding vessels can be successfully treated with bilateral selective angiographic embolization of the anterior branches of the hypogastric arteries.