Bilateral percutaneous nephrostomy as treatment for severe hemorrhagic cystitis.

OBJECTIVE: To report a case of severe hemorrhagic cystitis successfully treated by bilateral percutaneous nephrostomy. METHODS: The case of a 67-year-old female patient who had monosymptomatic gross hematuria with clots is reported. RESULTS: Standard conservative treatments failed and the patient developed a clot-retention plugged bladder. Endoscopic evacuation and electrocoagulation of bleeding areas was unsuccessful. Due to persistent hematuria and development of renal failure and hemodynamic instability, bilateral percutaneous nephrostomy was performed. At 24 hours, hematuria ceased, patient recovered hemodynamic stability, and no additional blood transfusions were required. CONCLUSIONS: Bilateral percutaneous nephrostomy may be a valuable option for the treatment of hemorrhagic cystitis when standard conservative measures have failed and as a prior step to performance of other more invasive procedures.

Nefrostomía percutánea bilateral como tratamiento de las cistitis hemorrágica severa / Bilateral percutaneous nephrostomy as treatment for severe hemorrhagic cystitis

OBJETIVO: Presentar un caso de cistitis hemorrágica severa tratada exitosamente mediante nefrostomía percutánea bilateral.MÉTODO: Presentamos el caso de una mujer de 67 años que presenta hematuria macroscópica monosintomática con coágulos.RESULTADOS: Fracaso de los tratamientos conservadores habituales y desarrollo de vejiga coagulada. Evacuación endoscópica y electrocoagulación de las áreas sangrantes sin éxito. Dada la persistencia de hematuria y desarrollo de insuficiencia renal e inestabilidad hemodinámica se decide nefrostomía percutánea bilateral. A las 24 horas cesa la hematuria, la paciente recupera la estabilidad hemodinámica y no requiere nuevas transfusiones sanguíneas.CONCLUSIONES: La realización de nefrostomía percutánea bilateral puede ser una opción útil en el tratamiento de la cistitis hemorrágica ante el fracaso de las medidas conservadoras habituales y como paso previo a la realización de otros tratamientos más invasivos(AU)

OBJECTIVE: To report a case of severe hemorrhagic cystitis successfully treated by bilateral percutaneous nephrostomy.METHODS: The case of a 67-year-old female patient who had monosymptomatic gross hematuria with clots is reported.RESULTS: Standard conservative treatments failed and the patient developed a clot-retention plugged bladder. Endoscopic evacuation and electrocoagulation of bleeding areas was unsuccessful. Due to persistent hematuria and development of renal failure and hemodynamic instability, bilateral percutaneous nephrostomy was performed. At 24 hours, hematuria ceased, patient recovered hemodynamic stability, and no additional blood transfusions were required.CONCLUSIONS: Bilateral percutaneous nephrostomy may be a valuable option for the treatment of hemorrhagic cystitis when standard conservative measures have failed and as a prior step to performance of other more invasive procedures(AU)