Endoscopic diagnosis of radiation cystitis

Introduction: Radiation cystitis is a rare complication in the radiotherapy of tumors in the small pelvis. The complaints are mostly irritable, with macroscopic hematuria with macroscopic profusion. The endoscopic finding is associated with telangiectasia, diffuse erythema, prominent submucosal blood vessels and bullous edema. The main diagnostic method is urethrocystoscopy. and Methods: For the period from 01.01.2015 to 01.01.2018 in the Urology Clinic of NOH, 44 patients who had radiation therapy and complained of macroscopic haematuria were hospitalized. The median time from the end of radiation to the onset of hematuria is 1.3 years. Radiated cystitis is more common in prostate cancer men and women with uterine cervical carcinoma. Results: Urethrostiscopy was performed in all patients with subsequent transurethral cleaning of the bladder. 18 patients undergo electrocoagulation of bleeding vessels, 4 transfusions, 7 patients were directed to intravesical therapy with sodium salts of hyaluronic acid. In one patient, ligation of the internal iliac arteries was performed due to the inability to stop the bleeding endoscopically. Discussion: Post-traumatic cystitis is observed in malignancy in the pelvis with subsequent radiotherapy. The main complaints are related to irritative symptoms and haematuria. This poses the issue of endoscopic diagnostics to avoid recurrence of the disease. The main thing is to coagulate bleeding and expanding potentially dangerous blood vessels. In the absence of an effect, an open surgical intervention with ligation of the internal iliac arteries and very rare cases of involuntary cystectomy can be achieved.