Hemorrhagic cystitis

Case contributed by Chris O'Donnell


Three days of severe lower abdominal pain, dysuria and gross hematuria with clots. No history of chemotherapy or radiation therapy to the pelvis.

Patient Data

Age: 45 years
Gender: Female



Gross circumferential swelling of the bladder wall, contraction of the lumen and marked inflammation in the adjacent fat without obvious perforation. Obstruction of the distal right ureter.

Case Discussion

Hemorrhagic cystitis is a diffuse inflammatory condition of the urinary bladder due to an infectious or noninfectious etiology, resulting in bleeding from the bladder mucosa. 

Chronic and recurrent hemorrhagic cystitis often results from anticancer chemotherapy or radiotherapy for the treatment of pelvic malignancies. Acute infectious etiologies (both viral and bacterial) are less common except in immunocompromised hosts like bone marrow transplant patients.

These cases can be challenging for the urologist and a source of substantial morbidity (and sometimes mortality) for patients.

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