Mendenhall William M, Henderson Randal H, Costa Joseph A, Hoppe Bradford S, Dagan Roi, Bryant Curtis M, Nichols Romaine C, Williams Christopher R, Harris Stephanie E, Mendenhall Nancy P
*Department of Radiation, University of Florida Proton Therapy Institute †Division of Urology, College of Medicine, University of Florida, Jacksonville, FL.
Am J Clin Oncol. 2015 Jun;38(3):331-6. doi: 10.1097/COC.0000000000000016.
The optimal management of persistent hemorrhagic radiation cystitis is ill-defined. Various options are available and include oral agents (ie, sodium pentosan polysulfate), intravenous drugs (ie, WF10), topical agents (ie, formalin), hyperbaric oxygen, and endoscopic procedures (ie, electrical cautery, argon plasma coagulation, laser coagulation). In general, it is best to manage patients conservatively and intervene only when necessary with the option least likely to exacerbate the cystitis. More aggressive measures should be employed only when more conservative approaches fail. Bladder biopsies should be avoided, unless findings suggest a bladder tumor, because they may precipitate a complication.
持续性出血性放射性膀胱炎的最佳管理尚不明确。有多种选择，包括口服药物（如戊聚糖多硫酸钠）、静脉用药（如WF10）、局部用药（如福尔马林）、高压氧治疗以及内镜手术（如电灼、氩离子凝固术、激光凝固术）。一般来说，最好对患者进行保守治疗，仅在必要时采用最不易加重膀胱炎的方法进行干预。只有当更保守的方法失败时，才应采取更积极的措施。除非检查结果提示膀胱肿瘤，否则应避免进行膀胱活检，因为活检可能引发并发症。
