Post-Radiation Cystitis: Current Treatments

Abstract

Radiation cystitis represents a relevant problem for people who have undergone pelvic radiation therapy. Radiation therapy is often used to cure prostate cancer and gynaecological malignancies, but bladder damage, due to induction of hypovascular tissue, is a frequent consequence. Urologists should be able to manage this condition, for many reasons: first, the patient’s life can be threatened by massive haematuria; second, also mild haematuria worsens significantly the patient’s life; and third, this condition has high social costs. Once the diagnosis is established, many therapeutic options are available: from intravesical therapies to systemic therapies. Hyperbaric oxygen therapy has a major role in improving radiation cystitis: it has been shown to be durable by many clinical studies. When all these therapies fail, surgical treatment represents the last choice. Unfortunately, few randomized clinical trials are available, so it is difficult to define the best treatment for patients. A step-based approach seems to be the best solution.