Haemorrhagic chronic radiation cystitis--following treatment of pelvic malignancies.

Haemorrhagic chronic radiation cystitis is not an uncommon clinical entity, and should be suspected in patients with painless gross haematuria who have a past history of radiotherapy to the pelvic region. A series of 29 patients with haemorrhagic chronic radiation cystitis were managed in the University Department of Surgery, Singapore General Hospital over a 5 years period from 1979 to 1983. Cystodiathermy was the mainstay of treatment and was successful in controlling haematuria in 27 patients. Two patients developed uncontrolled haematuria, urinary tract infection, septicaemia and died giving mortality of 6.9%. Excellent control of haemorrhage can be obtained with cystodiathermy in the majority of patients. Intravesical instillation of steroid or silver nitrate is used for the more intractable cases, after cystodiathermy. Urinary diversion with or without cystectomy are desperate measures to salvage the severe case and mortality is high.