Refractory hematuria post actinic cystitis. Role of potassium alumen as treatment - Case Report

Pinto Filho João Ernesto Aldred, Ejje Kailly Pedro Henrique, Louback Filho Ruston da Matta, Renteria Juan Miguel, Claudio Antonio, Cunha Ahouagi
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Abstract

Actinic cystitis hematuria is a frequent complication after pelvic radiotherapy, present in approximately 5% of patients exposed to this therapy. The management of these cases seems to be a challenge for today’s urologists. In this article, we present the case of a 73- year-old man diagnosed with actinic cystitis after pelvic radiotherapy and admitted to our service with a clinical picture of refractory macroscopic hematuria. During admission, the patient underwent multiple procedures and blood transfusions, without success in controlling hematuria. After a review of the literature, we chose to use Potassium Alum in the patient’s treatment. Under general anesthesia, we performed a cystoscopy with the evacuation of clots and subsequently infused a 1% solution of potassium alum into the bladder at a rate of 200 ml/h for 25 hours. Less than 24 hours after Alum infusion, there were no more clinical signs of hematuria, which remained until hospital discharge. After 6 months of treatment, the patient did not present another episode of hematuria.
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光化性膀胱炎后难治性血尿。钾铝治疗的作用-个案报告
光化性膀胱炎、血尿是盆腔放疗后常见的并发症,约5%的患者接受此治疗。这些病例的管理似乎是一个挑战,今天的泌尿科医生。在这篇文章中,我们报告一位73岁的男性病患,在接受盆腔放射治疗后被诊断为光化性膀胱炎,并以难治性肉眼血尿的临床表现入院。入院期间,患者接受了多次手术和输血,但未能成功控制血尿。在回顾文献后,我们选择使用钾明矾治疗患者。在全身麻醉下,我们进行膀胱镜检查并清除血块,随后以200 ml/h的速度向膀胱内注入1%的明矾钾溶液,持续25小时。明矾输注后不到24小时,患者不再出现血尿的临床症状,直至出院。治疗6个月后,患者未再出现血尿。
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