Introduction/Background Radiotherapy is commonly indicated in the treatment of gynaecological malignancies. Pelvic radiation can lead to a condition known as radiation cystitis in at least 5% of women cancer survivors. Treatment of gynaecological malignancies with radiotherapy delivers high-energy radiation to the pelvis, which can include the bladder epithelium and/or vasculature, and the detrusor muscle. This in turn can have long-term sequelae of incontinence, obstruction, pain, haematuria, ulceration, and fistulation.
Sodium hyaluronate (Cystistat®) bladder instillations have been established as a treatment option for bladder pain syndrome and recurrent urinary tract infections. There has been preliminary data to suggest its usefulness in radiation cystitis in men treated for prostate cancer. However, data is lacking in the cohort of women with radiation cystitis following treatment for gynaecological malignancy.
Methodology This was a retrospective review of patients attending a tertiary referral centre for gynaecology oncology over a 5-year period. Following cystoscopic assessment of bladder, patients received a standard regimen of sodium hyaluronate bladder instillations of weekly for 6 weeks, followed by 2 treatments at 6-weekly intervals.
Results Seventeen (17) patients were reviewed. Eleven patients were labelled as radiation cystitis, two patients had bladder pain syndrome following surgery alone for gynaecological malignancy, and four patients had bladder pain syndrome but no history of malignancy.
Of the patients with pelvic malignancy, 84% (11/13) reported improvement in symptoms following treatment and 76% (10/13) reported significant improvement. Of the patients treated with pelvic radiotherapy, 81% (9/11) reported significant improvement. All patients without history of malignancy (4/4) reported some improvement, and of these 75% (3/4) reported significant change.
Conclusion Bladder instillation of sodium hyaluronate was effective in reducing the symptoms of radiation cystitis in women treated for gynaecological malignancies.
Disclosure Nothing to disclose
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