1. The clinical research of 5 steps sequential method for whole treatment of hemorrhagic radiation cystitis in china.
- Author
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Ju Z, Yu W, Li Y, Han W, Tu X, Zhu S, and Zou Q
- Subjects
- Administration, Intravesical, Aged, Cystitis diagnosis, Cystitis etiology, Cystitis urine, Electrocoagulation methods, Embolization, Therapeutic methods, Female, Hematuria diagnosis, Hematuria etiology, Hematuria urine, Humans, Hyaluronic Acid administration & dosage, Hyperbaric Oxygenation methods, Male, Radiation Injuries diagnosis, Radiation Injuries etiology, Radiation Injuries urine, Retrospective Studies, Severity of Illness Index, Thrombin administration & dosage, Treatment Outcome, Critical Pathways, Cystitis therapy, Hematuria therapy, Pelvic Neoplasms radiotherapy, Radiation Injuries therapy
- Abstract
Background: Curing hemorrhagic cystitis remains a challenge. We explore a continuous and effective treatment for hemorrhagic radiation cystitis. Methods: The data of patients in 6 provincial cancer hospital urology departments between April 2015 and December 2019 was reviewed retrospectively. Patients were classified as moderate and severe groups. The 5-steps sequential method was adopted. Two groups were initiated with step 1 and step 3 respectively. Step 1 was symptomatic treatment. Thrombin solution or sodium hyaluronate was administrated for bladder irrigation in step 2. Step 3 was transurethral electrocoagulation. Step 4 was interventional embolization. Step 5 was HBO therapy. OABSS was used to assess the improvement of patients' symptoms. The outcome was evaluated after at least 6 months of follow-up. Results: A total of 650 patients (56 men and 594 women), mean age 71.2 years, were enrolled in the 5 steps sequential method. 582 patients were classified as moderate and 68 severe group. In moderate group, the cure rate of step 1 was 61.2% (356/582), 80.4% (468/582) after step 2, 93.1% (542/582) after step 3, 96.2% (560/582) after step 4, and 99.8% (581/582) after step 5. In severe group, the cure rate was 54.4% (37/68) after step 3, 76.5% (52/68) after step 4, and 94.1% (64/68) after the step 5 respectively. The mean OABSS scores of both groups significantly decreased after 5 steps sequential method treatment (P<0.01). Conclusions: Our results show hemorrhagic radiation cystitis can be cured in 5 steps, and the 5 steps sequential method is welcomed and effective. Therapy efficacy depends on the number of steps adopted and the severity of hematuria., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)
- Published
- 2021
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