How do you manage refractory radiation cystitis status post pelvic EBRT/BT?

Thankfully chronic radiation cystitis and specifically radiation-induced hemorrhagic cystitis is relatively rare (2-8%) [1]. However, it can be a chronic and debilitating complication after pelvic radiotherapy.

In managing these patients, first, I make sure to rule out another cause of cystitis – including infection, bleeding and recurrence. To rule out infection UA is first step. For bleeding, recurrence and to correctly diagnosis radiation cystitis the next step is cystoscopy with biopsy as ne...