040 68334455
WhatsApp
Patient Portal
Home Care
What is Hemorrhagic Cystitis?
Written by Medicover Team and Medically Reviewed by Dr Kalyan Babu Chinnibilli , Urologists
Hemorrhagic cystitis is a condition where the lining of the bladder becomes inflamed and bleeds. It leads to symptoms like blood in the urine, painful urination, and frequent urges to pee. The bleeding can range from mild to severe.
Key Facts:
- It is often a side effect of certain medications, such as chemotherapy (e.g., cyclophosphamide or ifosfamide)
- It can also be caused by radiation therapy, viral infections, or toxins
- It requires prompt treatment to prevent serious complications, such as bladder damage or infection
Who Might Get Hemorrhagic Cystitis?
Hemorrhagic cystitis can affect anyone, but certain people are at higher risk due to medical treatments or infections.
People at Higher Risk
- Cancer patients getting chemotherapy (like cyclophosphamide or ifosfamide)
- People are getting radiation therapy to the pelvis
- Those with viral infections, especially if the immune system is weak
- Bone marrow or stem cell transplant patients
- People taking certain medicines or exposed to bladder-irritating chemicals
How Common Is Hemorrhagic Cystitis?
Hemorrhagic cystitis is uncommon in the general population but more frequent in cancer or transplant patients. It affects up to 25% receiving certain chemotherapy drugs, 5-10% after pelvic radiation, and is also seen in viral infections in immunocompromised individuals. Early diagnosis and management are key to preventing complications.
What are the Causes of Hemorrhagic Cystitis?
Infections or non-infectious factors, such as medications or medical treatments, can cause hemorrhagic cystitis.
Infectious Causes
Certain germs can inflame the bladder and cause bleeding:
- Adenovirus: Seen in children and people with weak immune systems
- BK Virus: Common in kidney transplant patients
- Escherichia coli (E. coli): A frequent UTI germ that can sometimes cause bleeding
Non-Infectious Causes
These are often related to medical treatments:
- Chemotherapy: Drugs like cyclophosphamide and ifosfamide can irritate the bladder
- Radiation Therapy: Pelvic radiation may damage bladder tissue over time
- Medications: Blood thinners and some painkillers (NSAIDs) may increase bleeding risk
- Autoimmune Diseases: Conditions like lupus can cause bladder inflammation
Risk Factors for Hemorrhagic Cystitis
Several factors can elevate the risk of developing hemorrhagic cystitis. These include:
- Cancer Treatments: Chemotherapy and radiation therapy are significant risk factors.
- Immunosuppression: Patients with weakened immune systems, such as transplant recipients, are more susceptible.
- Pre-existing Bladder Conditions: Chronic bladder inflammation or infection can predispose to hemorrhagic cystitis.
- Age and Gender: Children and older adults are at higher risk, with males being more susceptible due to the prostate's involvement in urinary function.
Get a second opinion from trusted experts and makeconfident, informed decisions.
Get Second OpinionWhat are the Symptoms of Hemorrhagic Cystitis?
Hemorrhagic cystitis causes bladder irritation and bleeding, leading to noticeable urinary symptoms.
Common Signs of Hemorrhagic Cystitis
- Blood in the urine (pink, red, or cola-colored)
- Pain or burning during urination
- Frequent urge to urinate
- Lower abdominal or pelvic pain
- Difficulty passing urine
- Strong-smelling urine
- In severe cases: clots in urine or inability to urinate
If you notice blood in your urine or discomfort while urinating, especially after chemo or radiation, see a doctor right away.
How is Hemorrhagic Cystitis Diagnosed?
Diagnosing hemorrhagic cystitis early helps guide the proper treatment and prevent serious problems. Doctors use a mix of questions, lab tests, scans, and direct bladder exams to confirm the cause.
Clinical Evaluation
- Medical History: The doctor will ask about past chemotherapy, radiation treatment, medications, and medical conditions such as transplants or infections.
- Symptoms check: You'll be asked about the colour of your urine, pain during urination, frequency, and when the symptoms started.
Laboratory Tests
- Urinalysis: Checks for the presence of blood, white blood cells, or signs of infection.
- Urine culture: Helps find out if bacteria are causing the problem.
- Viral PCR tests: Used to detect BK virus, adenovirus, or other viruses in high-risk patients.
Imaging Tests
- Ultrasound: Shows changes in the bladder wall or blood clots.
- CT scan: Gives detailed pictures if a more serious or complex issue is suspected.
Cystoscopy
- A thin tube with a camera is placed into the bladder to see the inside directly.
- This helps identify the source of bleeding, assess for damage, and collect a biopsy if necessary.
Doctors may use a grading system to measure how severe the bleeding is:
- Grade I: Mild bleeding seen only under a microscope (no visible blood in urine)
- Grade II: Visible blood in urine, but bleeding is light.
- Grade III: Heavier bleeding with small clots in the urine
- Grade IV: Severe bleeding with large clots that may block urine flow
What are the Treatment Options for Hemorrhagic Cystitis?
Treatment for hemorrhagic cystitis focuses on relieving symptoms, treating the cause, and preventing complications. Care may include Medical Management (First Steps)
- Hydration: Drinking plenty of fluids helps flush out the bladder and prevent blood clots from forming.
- Pain relief: Painkillers and bladder relaxants (antispasmodics) help reduce discomfort during urination.
- Bladder irrigation: A steady flow of saline or special solutions is used to wash out the bladder and reduce bleeding.
Medications
- Antiviral drugs: Used when viruses like the BK virus or adenovirus are the cause (e.g., cidofovir).
- Mesna: Given to patients on cyclophosphamide or ifosfamide to protect the bladder lining from damage.
- Anti-inflammatory medicines: Corticosteroids or similar drugs can help calm bladder irritation.
Surgical or Advanced Procedures
- Cystoscopy: A small camera is used to view the bladder and seal bleeding areas or remove clots.
- Intravesical therapy: Medications such as alum, formalin, or hyaluronic acid are placed directly into the bladder to stop bleeding.
- Hyperbaric oxygen therapy: Delivers oxygen under pressure to help heal damaged bladder tissue (used in stubborn or chronic cases).
- Urinary diversion: In sporadic, severe cases, the urine may be temporarily or permanently rerouted away from the bladder.
Early treatment improves outcomes and lowers the risk of complications like bladder scarring or urinary blockages.
When to See a Doctor for Hemorrhagic Cystitis?
You should contact your doctor right away if you notice:
- Blood in your urine (pink, red, or dark brown)
- Pain or burning while urinating
- Frequent or urgent need to urinate
- Clots in the urine or trouble passing urine
- Lower belly pain or pressure
These symptoms may point to hemorrhagic cystitis, especially if you've had chemotherapy, radiation, or a transplant. Early treatment can prevent serious complications, such as urinary blockage or infection.
Your health is everything - prioritize your well-being today.
Consult Hemorrhagic Cystitis Doctors Today
Therapies for Hemorrhagic Cystitis
Chemotherapy-Induced Hemorrhagic Cystitis
Some chemotherapy drugs, especially cyclophosphamide and ifosfamide, can cause bleeding and irritation in the bladder. This is called chemotherapy-induced hemorrhagic cystitis.
Key Prevention Measures
- Hydration and Diuresis: Drinking lots of fluids and sometimes using medications to increase urine flow. This helps flush out harmful substances from the bladder.
- Mesna (Uroprotective Agent): A medicine given alongside chemotherapy. It binds to toxic byproducts and protects the bladder lining from damage.
Radiation Therapy and Hemorrhagic Cystitis
Radiation to the pelvis (for cancers of the bladder, prostate, cervix, etc.) can irritate the bladder and cause bleeding. This condition may appear soon after treatment (acute) or months to years later (chronic).
Management Options
- Bladder Irrigation: Helps flush out blood, clots, and irritants to ease symptoms and prevent blockages.
- Anti-inflammatory Medications: Used to calm bladder inflammation caused by radiation.
- Hyperbaric Oxygen Therapy (HBOT): Delivers high-pressure oxygen to help the bladder lining heal. Often used in cases of chronic or severe conditions.
Early care and regular follow-up are crucial for managing symptoms and preventing long-term damage.
Our Experience in Treating Hemorrhagic Cystitis
At Medicover Hospitals, we care for many patients with hemorrhagic cystitis, especially those receiving chemotherapy, radiation, or transplants. Our expert urology team collaborates to provide fast, safe, and personalised treatment.
What We Do:
- Early detection: We use urine tests, scans, and cystoscopy to find and assess bleeding
- Chemotherapy care: We prevent bladder damage with Mesna and plenty of fluids
- Radiation care: We manage side effects using bladder washes and oxygen therapy
- Viral treatment: We treat virus-related cases, especially in transplant patients
- 24/7 support: Our urology team is always available for urgent symptoms
- Safe procedures: We remove clots and treat the bladder using gentle, advanced methods
We focus on fast relief, full recovery, and preventing long-term problems, so our patients feel better, faster.
