Simple innocuous treatment of massive cyclophosphamide hemorrhagic cystitis.

A rare complication of cyclophosphamide therapy is severe, protracted, and often life-threatening hemorrhagic cystitis. Many reports on the management of this problem have advocated invasive and in themselves dangerous methods. It is proposed that this condition can be managed by suprapubic cystotomy with the fulguration of obvious bleeding points and the placement of two suprapubic tubes. High-flow continuous bladder irrigation can then be instituted using cooled saline. In addition, the patient should be sedated and constipation avoided.