Side Effect: Hemorrhagic cystitis

What is hemorrhagic cystitis?

Hemorrhagic cystitis occurs when the lining of the bladder becomes irritated to the point where it bleeds.

What does hemorrhagic cystitis look like?

Hemorrhagic cystitis is most noticeable when blood turns the urine orange, pink, or red. A small amount of blood can change the color of urine, which may be alarming, but is not always a sign of severe blood loss. Regardless of how much blood is in the urine, any blood in the urine is considered abnormal and a reason to seek immediate medical attention to prevent the bleeding from getting worse.

Who gets hemorrhagic cystitis?

Certain types of medications can increase the risk of hemorrhagic cystis. The most common being ifosfamide. A similar chemotherapy agent know as cyclophosphamide rarely leads to blood in the urine when given intravenously.

An infection known as BK virus is a rare cause of hemorrhagic cystitis and usually only occurs in people who have been immunocompromised for a long period of time, such as those with HIV infection, or those who have areceived a stem cell transplant from a donor (allogeneic transplant).

How long does hemorrhagic cystitis last?

The duration of bleeding depends upon the cause and the severity of injury to the bladder wall. On occasion, patients require hospitalization if the injury is severe.

How do you prevent hemorrhagic cystitis?

Nearly all cases of hemorrhagic cystitis from ifosifamide can be prevented using a medication known as MESNA.

• MESNA is NOT chemotherapy, it is a bladder protectant that neutralizes the toxic metabolite of ifosfamide and cyclophosphamide, known as acrolein
• MESNA is an acronym thast stands for MercaptoEthaneSulfonate Sodium (sodium is abbreviate as Na⁺) = MESNA

MESNA is routinely given with any chemotherapy regimen that includes ifosfamide, and some cyclophosphamide-containing regimens that have doses or durations high enough to cause hemorrhagic cystitis.

How do you treat hemorrhagic cystitis?

If the hemorrhagic cystitis is due to ifosfmaide or cyclophosphamide, additional MESNA will likely be given. If the bleeding from the bladder is severe, patients may require hospitalization for continuous bladder irrigation as directed by urologists.

If the hemorrhagic cystitis is due to infection, antoviral medication may be prescribed and will likely be administered intravenously