Articles Tập 67 Số CĐ13-HNKH Bệnh viện 19-8 10/09/2026

INITIAL RESULTS ARTERIAL EMBOLIZATION OF TREATMENT OF BLEEDING CYSTITIS AFTER RADIATION THERAPY  

Giang Phan Hoang, Hoàng Nguyễn Huy
DOI: 10.52163/yhc.v67iCD13.6411
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Keywords
cystitis after radiation therapy, hematuria, embolization
Abstract

Abstract

Hemorrhagic cystitis is a common complication after radiation therapy for pelvic cancers: rectal cancer, cervical cancer, and prostate cancer. This pathology causes prolonged bleeding, and medical treatment and hemostasis after endoscopy are ineffective.

Objectives: To initially evaluate the results of embolization in the treatment of cystitis after radiotherapy to the pelvic region.

Subjects and research methods: from July 2021 to August 2025 at Radiology Department - Bach Mai Hospital, there were 15 patients with cystitis after radiation therapy with persistent bleeding, cystoscopy with inflammation vascular proliferation, MSCT of the thickened bladder wall, medical treatment, endoscopic hemostasis are not effective. These patients were selected for superior bladder artery embolization, middle bladder artery, and inferior bladder artery and followed up for 1, 3, and 6 months.

Results: 15 patients with different blood loss status. 14 patients were technically successful (1 patient had a dissection of the vascular wall requiring embolization from the contralateral side), 13 clinically successful patients were no longer hematuria after 3 months, 1 patient had dysmenorrhea. urination, 1 patient still had hematuria after the intervention. No major complications

Conclusion: Embolization for the treatment of hematuria due to cystitis after radiation therapy is a safe and effective treatment.

References
[1]
1. Gowda GG, Vijayakumar R, Tigga MP. Endovascular Management of Radiation-Induced Hemorrhagic Cystitis. Indian J Palliat Care. 2019;25(3):471-473. doi:10.4103/IJPC.IJPC_6_19 Google Scholar
[2]
2. Nitta M, Tazawa M, Naruse J, et al. Two Cases of Intractable Radiation-Induced Hemorrhagic Cystitis Treated with Transcatheter Embolization. Google Scholar
[3]
3. Goucher G, Saad F, Lukka H, Kapoor A. Canadian Urological Association Best Practice Report: Diagnosis and management of radiation-induced hemorrhagic cystitis. Can Urol Assoc J. 2019;13(2):15-23. doi:10.5489/cuaj.5788 Google Scholar
[4]
4. Mohan S, Kumar S, Dubey D, Phadke RV, Baijal SS, Kathuria M. Superselective vesical artery embolization in the management of intractable hematuria secondary to hemorrhagic cystitis. World J Urol. 2019;37(10):2175-2182. doi:10.1007/s00345-018-2604-0 Google Scholar
[5]
5. Tsitskari M, Spiliopoulos S, Konstantos C, Palialexis K, Reppas L, Brountzos E. Long-term results of super-selective trans-catheter embolization of the vesical arteries for the treatment of intractable bladder haematuria. CVIR Endovasc. 2020;3:97. doi:10.1186/s42155-020-00188-1 Google Scholar
[6]
6. Ward JF, Velling TE. Transcatheter Therapeutic Embolization of Genitourinary Pathology. Rev Urol. 2000;2(4):236-252. Google Scholar
[7]
7. Alarayedh A, Abdulwahab S, Mubarak M. Super-Selective Trans-Catheter Arterial Embolization (TAE) of the Vesical Arteries in the Management of Intractable Hematuria Secondary to Advanced Bladder and Prostate Cancers. Cureus. 16(4):e58016. doi:10.7759/cureus.58016 Google Scholar
[8]
8. Zhou C, Zhou CG, Wang B, Liu XL, Shi HB, Liu S. Superselective Vesical Artery Embolization for Intractable Hemorrhagic Cystitis Following Hematopoietic Stem Cell Transplantation: A Single-Center Retrospective Study in 26 Patients. Cardiovasc Intervent Radiol. 2021;44(6):943-951. doi:10.1007/s00270-021-02786-5 Google Scholar
[9]
9. Yung KS, Chung PM, Wong SC, et al. Transcatheter Arterial Embolization of Vesical Arteries for Intractable Hematuria: Effectiveness and Safety in 36 Patients. J Vasc Interv Radiol. 2025;36(7):1153-1159.e1. doi:10.1016/j.jvir.2025.03.015 Google Scholar