Hemorrhagic Cystitis - Drugs for the Treatment of Hemorrhagic Cystitis

hemorrhagic a clinical picture characterized by an inflammatory process - sometimes infectious - in the mucosa of the bladder, associated with a "macroscopic hematuria; more often than not, hemorrhagic cystitis reflects a traumatic event affecting the bladder (eg chemotherapy) or administration of a toxic substance.

• Pathogens - radiation - drugs → Injury to the transitional epithelium of the bladder and underlying blood vessels → haemorrhagic cystitis

, S. saprophyticus, Klebsiella, Pseudomonas, etc.), virus (Adenovirus, influenza A virus and Cytomegalovirus) or fungi (rarer); however, this variant of cystitis has been found in haemorrhagic diathesis, generalized sepsis and in some syndromes. The so-called "sterile" haemorrhagic cystitis is the expression of NON-infectious lesions, such as radiotherapy and chemotherapy.

• Risk factors: AIDS, kidney stones (rare), urinary catheter, diabetes, gonorrhea, incorrect intimate hygiene, risky sexual intercourse, bladder tumors (rare), use of the diaphragm and spermicides, excessive use of intravaginal tampons.

they materialize in inflammatory phenomena associated with more or less serious bleeding lesions. In general, the affected patient always complains of blood in the urine (haematuria), possibly associated with dysuria, suprapubic pain, pollakiuria, stranguria, bladder tenesmus.

The information on Medicines for the Treatment of Hemorrhagic Cystitis is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Medicines for the Treatment of Hemorrhagic Cystitis.

To learn more: Hemorrhagic hemorrhagic cystitis is subordinated to the underlying cause: when the disease is triggered by a bacterial insult, antibiotic drugs are the therapy of excellence. It is possible to choose antibiotics with a broad spectrum of action if the pathogen responsible for haemorrhagic cystitis has not yet been identified with certainty; if the bacterium is isolated, the doctor will indicate a specific antibiotic. fungi: the former are eradicated with the administration of specific antivirals, while the fungi are killed with antifungals.
As we have analyzed, hemorrhagic cystitis can also be of an extra-infectious nature, and depend on radiation, antineoplastic drugs or congenital malformations.
It is estimated that 5-30% of patients treated with cyclophosphamide or ifosfamide develop bladder damage such as haemorrhagic cystitis: to avoid this inconvenience, it is recommended to undertake a specific therapy aimed at the PREVENTION of haemorrhagic cystitis.

Below are some of the drugs most commonly used in therapy for the treatment of hemorrhagic cystitis, and some examples of pharmacological specialties. It is up to the doctor to choose the most suitable active ingredient and dosage for the patient based on the triggering cause, the severity of the disease and the patient's response to treatment.

Antibiotic therapy for the treatment of bacterial hemorrhagic cystitis

• Imipenem: the drug (class: beta-lactam antibiotics) is used in therapy for the treatment of complicated bacterial infections of the urinary tract caused by Klebsiella And Pseudomonas.
• Third generation cephalosporins, also used in cases of severe Gram-negative bacterial infections that are difficult to treat.
• Piperacillin: this is a semi-synthetic pensicillin used in the treatment of complicated urinary tract infections (especially those caused by Pseudomonas aeruginosa, Klebsiella, Enterobacter, Escherichia coli, Neisseria gonorrhoeae etc.).

Antispastic therapy for hemorrhagic cystitis

• Scopolamine butylbromide: your doctor can prescribe it for the symptomatic treatment of painful spasms that can accompany hemorrhagic cystitis.

Analgesic drugs for the control of pain associated with hemorrhagic cystitis

There are several medicines of this type that can be used to relieve the pain caused by hemorrhagic cystitis. The doctor will prescribe the right active ingredient for each patient.

Systemic hyperhydration in case of hemorrhagic cystitis

The aim of this therapy, which involves intravenous administration of fluids, is to minimize the fatigue of the bladder detrusor muscle, while limiting, at the same time, the permanence of the urine in contact with the injured mucosa. The doctor will decide how and how to administer the patient.

Drugs to promote diuresis

Forced diuresis is another possible alternative or complementary therapy in the context of haemorrhagic cystitis. Therefore, diuretic drugs will be used. It will be the doctor who will determine the most suitable active ingredient for each patient.

Supportive therapy with blood products for hemorrhagic cystitis

If necessary, the doctor may prescribe the administration of blood products in order to make up for any blood loss.

Urine alkalinization for the treatment of haemorrhagic cystitis

Alkalization of the urine is an effective method for the prevention of haemorrhagic cystitis in the context of chemotherapy (methotrexate, cyclophosphamide and isophosphamide).

The specialist will decide which drug to use and in what dosage on a strictly individual basis for each patient.

Preventive therapy for hemorrhagic cystitis in cancer patients

Some patients receiving chemotherapy for the treatment of cancer are advised to administer certain drugs aimed at preventing hemorrhagic cystitis: antineoplastic medicines containing cyclophosphamide or ifosfamide, in fact, seem to increase the risk of causing hemorrhagic cystitis to those who take them. The dose-limiting toxicity of isophosphamide occurs mainly in the bladder and kidneys.

In such circumstances, it is recommended to administer the principle attium mesna (2-mercaptoethane-sodium sulphonate) intravenously at a dose equal to 20% of the dose of ifosfamide (or other oxazafosphorins, such as cyclophosphamide) and subsequently at a distance of 4 and 8 hours.

Clearly, such drugs can only be administered by trained healthcare professionals.