MP20-18 GRADE 4 HEMORRHAGE RADIATION CYSTITIS TREATED BY EARLY TRANSURETHRAL FULGURATION VERSUS CONSERVATIVE OBSERVATION STRATEGY: OUTCOME COMPARISON FROM 283 CASES

Abstract

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Kidney & Bladder II1 Apr 2015MP20-18 GRADE 4 HEMORRHAGE RADIATION CYSTITIS TREATED BY EARLY TRANSURETHRAL FULGURATION VERSUS CONSERVATIVE OBSERVATION STRATEGY: OUTCOME COMPARISON FROM 283 CASES Toru Sugiahra, Hideo Yasunaga, Jun Kamei, Hiroki Matsui, Tohru Nakagawa, Tetsuya Fujimura, Hiroshi Fukuhara, Haruki Kume, Kiyohide Fushimi, Masaaki Tachibana, and Yukio Homma Toru SugiahraToru Sugiahra More articles by this author , Hideo YasunagaHideo Yasunaga More articles by this author , Jun KameiJun Kamei More articles by this author , Hiroki MatsuiHiroki Matsui More articles by this author , Tohru NakagawaTohru Nakagawa More articles by this author , Tetsuya FujimuraTetsuya Fujimura More articles by this author , Hiroshi FukuharaHiroshi Fukuhara More articles by this author , Haruki KumeHaruki Kume More articles by this author , Kiyohide FushimiKiyohide Fushimi More articles by this author , Masaaki TachibanaMasaaki Tachibana More articles by this author , and Yukio HommaYukio Homma More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.990AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Despite a severity of hemorrhage radiation cystitis (HRC), evidence for its treatment strategy has been limited, especially in intervention timing of transurethral fulguration (TUF). In the present study, length of hospital stay (LOS) among grade 4 HRC patients was compared between early TUF group and observation groups. METHODS Patients who were hospitalized because of radiation cystitis (ICD-10 code: N304) and received transfusion by 3rd day from admission were identified from the Japanese national clinical database named the Diagnosis Procedure Combination (DPC) database 2007 – 2012. Patients were classified into three strategy groups: 1) early TUF group (performed within 4 day from admission), 2) late TUF group (5 to 21 day), and 3) observation group (no TUF within 21 day). The three strategy groups were compared by Kaplan-Meier curve for discharge event and multivariate analysis using a Cox proportional hazard model for discharge event. Multivariate model included sex, age, comorbidity, and use of hyperbaric oxygen therapy. RESULTS Two hundred and eighty-three patients were extracted from the database. Median LOSs were 11 days in early TUF group (n=65), 20 days in late TUF group (n=32), and 20 days in observation group (n=186). Figure 1 showed Kaplan-Meier curves of three groups. (Log-rank test, p < 0.01) Multivariate analysis resulted that hazard ratios of discharge event based on early TUF group were 0.65 (p = 0.048) in late TUF group and 0.69 (p = 0.014) in observation groups. CONCLUSIONS The result of the present study suggested early TUF was associated with early discharge and would support that early TUF strategy could be a reasonable option for severe HRC. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e230 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Toru Sugiahra More articles by this author Hideo Yasunaga More articles by this author Jun Kamei More articles by this author Hiroki Matsui More articles by this author Tohru Nakagawa More articles by this author Tetsuya Fujimura More articles by this author Hiroshi Fukuhara More articles by this author Haruki Kume More articles by this author Kiyohide Fushimi More articles by this author Masaaki Tachibana More articles by this author Yukio Homma More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...