Department of Urology, University of California San Francisco, San Francisco, CA, USA.
Department of Urology, University of Iowa, Iowa City, IA, USA.
BJU Int. 2023 Dec;132(6):631-637. doi: 10.1111/bju.16140. Epub 2023 Aug 9.
Haemorrhagic cystitis (HC) is characterised by persistent haematuria and lower urinary tract symptoms following radiotherapy or chemotherapy. Its pathogenesis is poorly understood but thought to be related to acrolein toxicity following chemotherapy or fibrosis/vascular remodelling after radiotherapy. There is no standard of care for patients with HC, although existing strategies including fulguration, hyperbaric oxygen therapy, botulinum toxin A, and other intravesical therapies have demonstrated short-term efficacy in cohort studies. Novel agents including liposomal tacrolimus are promising targets for further research. This review summarises the incidence and pathogenesis of HC as well as current evidence supporting its different management strategies.
出血性膀胱炎 (HC) 的特征是在放疗或化疗后出现持续性血尿和下尿路症状。其发病机制尚不清楚，但被认为与化疗后的丙烯醛毒性或放疗后的纤维化/血管重塑有关。目前尚无 HC 患者的标准治疗方法，尽管包括电灼、高压氧治疗、肉毒杆菌毒素 A 以及其他膀胱内治疗在内的现有策略在队列研究中显示出短期疗效。包括脂质体他克莫司在内的新型药物是进一步研究的有希望的靶点。本综述总结了 HC 的发病率和发病机制以及支持其不同管理策略的现有证据。
