What Is Radiation Cystitis?

Radiation therapy for pelvic tumors and cervical cancer, the bladder is one of the unavoidable irradiated organs. Although the radiosensitivity of the bladder mucosa is lower than that of the intestinal mucosa, after large doses of radiation, radiation cystitis is still inevitable and the incidence It is 2.48% to 5.6%. The occurrence of radiation cystitis is related to the total radiation dose, radiation therapy technology and individual radiation sensitivity differences. Advances in radiotherapy technology cannot change the anatomical relationship between the lesion and the bladder and rectum during the treatment of uterine cancer; if the lesion is exposed to a sufficient amount, it will definitely affect the adjacent organs.

Radiation cystitis

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It is generally believed that the bladder has a lower radiosensitivity than the rectum, and ulcers occur more than 60Gy. Radiation cystitis is mainly caused by radiation-induced vascular damage, small blood vessel occlusion, and mucosal congestion and edema, resulting in ulcers. There is obvious edema around it, and infection and bleeding are often associated. After the ulcer healed, there were white scars, and reticular vasodilatations were seen around it. Vascular rupture caused repeated bleeding, even after 10 years of radiotherapy.

(1) Mild: Only mild symptoms and signs, such as urgency, frequent urination, and dysuria.

1. Have a history of bladder area or intravaginal radiation therapy. 2. May be painless hematuria, mild frequent urination or dysuria and difficulty urinating. Severe hematuria can cause anemia. 3. Urine routine examination has a lot of red blood cells. The tumor cells were negative. 4.

For mild and moderate acute radiation cystitis, conservative treatments such as antibiotic anti-inflammatory, hemostatic and symptomatic treatment are mainly used to relieve bladder irritation. The drug can be used systemically in a similar way to general cystitis. The common local treatments are as follows:

(1) Drug bladder rinse. Benzocaine (0.3 g), Belladonna (0.5 g), Belladonna (0.5 g), gentamicin (120,000 u), and dexamethasone (1.5 mg) were added to normal saline to 30 ml, and bladder perfusion was performed twice a day.

(2) Infuse 50% 2% benzocaine through a catheter, and keep it for 5 minutes, and inject 150% to 200ml of 4% formaldehyde solution (the amount can be adjusted according to the bladder capacity). Keep it for "minutes to release, then inject 200% 50% alcohol, rinse 2 This method is mainly used for the treatment of hemorrhagic cystitis.

(3) Bladder infusion therapy with alum solution. Alum solution is an astringent that is not absorbed by the body. It can precipitate proteins on the bleeding surface, reduce cell membrane permeability, and harden capillary endothelial cell adhesion, thereby slowing plasma protein flow in the capillary. Tissue edema, inflammation and exudation were alleviated and bleeding stopped. Before use, rinse the bladder with a three-cavity Foley tube with normal saline, drain as much blood clots as possible, and then infuse the bladder with 250% 1% alum solution, leave it for 20 minutes and drain. The same method can be repeated three times.

(4) Transurethral electrocoagulation to stop bleeding. Due to poor blood supply to the damaged tissue, it is easy to form fibrosis, the regeneration function is low, and the coagulation site is prone to necrosis. Therefore, care should be taken to prevent the formation of fistula.

(5) Anterior closure therapy. Between the rectum and the coccyx, 0.25% procaine 80-100ml was used for invasive sealing, once every 5-7 days. After 2 or 3 treatments, symptoms may be relieved.

(6) Others: there are reports. a-chymotrypsin has the effects of anti-inflammatory, anti-edema, dissolving cellulose, decomposing mucus, etc., and has a certain effect for the treatment of radiation cystitis. Intramuscular injection of 25u daily for a total of 2 to 4 weeks, symptoms and signs can be significantly improved. Hyperbaric oxygen can increase the oxygen tension in the tissue, the formation of new blood vessels and granulation tissue, and repair of tissue damage, thereby promoting inflammation and healing. Conditional units, hyperbaric oxygen can be used as a means of treating radiation cystitis. The patient inhaled 100% oxygen in the hyperbaric oxygen chamber, once a day, 90 minutes each time, 5-6 times a week, a total of 20 times, and reported good results.

Subacute ulcers are given conservative therapy first, as in the acute phase. People who have suffered a lot of blood loss need to receive fresh blood to improve the general condition. Chronic periods such as decreased bladder capacity, bladder wall sclerosis, and urinary stenosis can cause hydronephrosis. Severe cases can induce uremia, and surgical treatment is needed.