Successful management of severe refractory haemorrhagic cystitis secondary to cyclophosphamide and BK virus with cystotomy and alum infusion.

A 36-year-old male patient is referred for urology review for haematuria following cyclophosphamide and mesna administration for allogeneic stem cell transplant for treatment of acute lymphoblastic leukaemia. Severe haematuria continued despite multiple interventions including continuous bladder irrigation and cystoscopic fulguration, with formation of consolidated clot in the bladder. A successful cystotomy for removal of clot and initiation of alum was performed, leading to resolution of haematuria.