Successful Treatment of Severe Hemorrhagic Cystitis Following Allogeneic Stem Cell Transplantation by Selective Embolization of Bilateral Hypogastric Arteries.

Objective Hemorrhagic cystitis(HC) is a common complication of allogeneic stem cell transplantation occurring in 7–52% of transplant recipients. The severity of HC can range from mild hematuria to life-threatening bleeding with urinary tract obstruction or renal insufficiency. Severe HC is often refractory to the conventional therapy. Currrent treatment modalities for severe HC include selective embolization of the hypogastric arteries and hyperbaric oxygen. We studied 6 patients with refractory severe HC to investigate the therapeutic value of embolization in severe HC following allogeneic stem cell transplantation. Methods 6 patients underwent allogeneic stem cell transplantation developed severe HC with a median onset time of 33 d after transplatation. All these patients had been resistant to conservative managements and received the treatment of selective embolization of hypogastric arteries. Results 8 times of embolizations were performed for 6 patients. The HC resolved in 4 patients and the HC improved in 1 patient, yielding a response rate of 83%. One patient didn’t respond to this measure. For the patients with response, macroscopic hematuria disappeared 7 to 10 days after the treatments and microscopic hematuria vanished 20 to 30 days after the intervention therapy. Both procedures were tolerated well and no severe adverse effects were observed. Conclusion It suggest that selective embolization of hypogastric arteries seems to be a safe and effective treatment for severe HC. This measure can be proposed for patients undergoing refractory and persistent severe HC.