Bladder, ureter & renal pelvis
Cystitis
Hemorrhagic cystitis
Author: Monika Roychowdhury, M.D.
Last author update: 1 May 2015
Last staff update: 1 November 2021
Copyright: 2003-2023, PathologyOutlines.com, Inc.
PubMed Search: hemorrhagic cystitis
Table of Contents
Definition / general | Etiology | Clinical features | Case reports | Treatment | Clinical images | Gross images | Microscopic (histologic) images | Cytology images | Differential diagnosisCite this page: Roychowdhury M. Hemorrhagic cystitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/bladderhemorrhagiccystitis.html. Accessed September 21st, 2023.
Definition / general
- Clinical syndrome of gross hematuria, often with irritative bladder symptoms
Etiology
- Due to drug treatment (cyclophosphamide, methotrexate, ifosphamide), radiation therapy (eMedicine: Hemorrhagic Cystitis [Accessed 11 July 2018]), viral infection (adenovirus, herpes simplex virus, CMV, BK virus)
- Post allogeneic hematopoietic stem cell transplantation (Chin Med J (Engl) 2008;121:1766)
- Occurs in 10% of pediatric bone marrow transplants (J Pediatr Urol 2009;5:254)
Clinical features
- Irritative voiding symptoms, gross hematuria
Case reports
- 8 year old with BK virus associated hemorrhagic cystitis presenting as mural nodules (Pediatr Radiol 2010;40:1430)
- 47 year old man with malaise and recent UTI, with voided urine specimen (Case of the Week #353)
- 49 year old man with symptoms after receiving penicillin for endocarditis (Intern Med 2009;48:1667)
- 70 year old man with hemorrhagic cystitis due to melphalan (Case Rep Med 2010;2010:569138)
Treatment
- Clot evacuation and hydration, bladder irrigation with saline or alkalinized saline, intravesical instillation of aluminium hydroxide / magnesium hydroxide
- More aggressive therapies include transurethral coagulation of bladder, fixation with silver nitrate and formalin, embolization of internal iliac arteries or their branches to the bladder; rarely requires cystectomy
Clinical images
Images hosted on other servers:
Inflammatory bleeding bladder mucosa
Gross images
Images hosted on other servers:
Hemorrhagic and ulcerative cystitis after cyclophosphamide
Microscopic (histologic) images
Images hosted on other servers:
Edema, bleeding and granulocyte infiltration
Hemorrhage and edema in the lamina propria
Cytology images
Case of the Week #353
47 year old man with herpes viral cytopathic effects in urine cytology
Differential diagnosis
- Hemorrhage associated with malignancy
