A Complete Guide to Hemorrhagic Cystitis

Hemorrhagic cystitis is an uncommon condition that can develop due to a variety of underlying causes.

It’s a condition that can lead to significant health concerns and complications, especially if it’s left untreated.

That’s why it’s important to know which symptoms to look out for and the steps you should take if you suspect that you’ve developed hemorrhagic cystitis.

What is Hemorrhagic Cystitis?

Hemorrhagic cystitis is a medical condition that causes the bladder lining to become irritated and inflamed. This can lead to bleeding within the bladder.

The severity of hemorrhagic cystitis can vary significantly and may cause discomfort that ranges from mild to severe.

Although this condition can affect anyone, certain groups of people are more at risk, including:

• Individuals with viral infections
• People with a history of bladder irritation
• Older individuals
• People with compromised immune systems
• People receiving cancer treatments
• Bone marrow or stem cell transplant recipients

It’s important to seek treatment as soon as you suspect that you may have hemorrhagic cystitis to prevent further complications. Symptoms of hemorrhagic cystitis

Symptoms of hemorrhagic cystitis can vary in severity, but typically include the following:

• Blood in the urine (hematuria)
• Painful urination
• Increased frequency and urgency to urinate
• Lower abdominal pain or discomfort
• Urinary incontinence

If your hemorrhagic cystitis is associated with urinary tract infections (UTI), you may also experience symptoms like fever, chills, and a general feeling of discomfort.

What are the Causes of Hemorrhagic Cystitis?

There are a number of factors that can contribute to the development of hemorrhagic cystitis, including infections, surgical procedures, medication, and environmental pollutants.

Let’s take a closer look at the most common causes.

Bacterial or viral infection

One of the primary causes of hemorrhagic cystitis is a bacterial or viral infection.

Bacterial UTIs develop when bacteria enter the urinary tract and irritate the bladder lining.

This usually occurs when you don’t properly wipe or clean the genital area after a bowel movement, allowing bacteria to move into the urinary tract.

Infection by certain adenovirus strains or the BK polyomavirus can also cause viral hemorrhagic cystitis to develop.

These viruses directly infect the cells in the bladder lining, leading to cellular damage, inflammation, and bleeding.

Individuals with compromised immune systems and medical conditions like HIV/AIDS are most susceptible to developing hemorrhagic cystitis through viral infections.

Chemotherapy and radiation

Chemotherapy drugs — such as cyclophosphamide and ifosfamide — are known to contribute to the development of hemorrhagic cystitis.

These drugs are metabolized by the body to produce a toxic byproduct — known as acrolein — meant to kill cancerous cells.

However, the byproducts can irritate and damage the bladder lining, making it more susceptible to infection and bleeding.

Radiation therapy can also damage the bladder and cause hemorrhagic cystitis, particularly when treatments are aimed directly at the pelvic area.

This kind of direct treatment is usually given to patients with cervical, prostate, or bladder cancer that requires an aggressive method to target tumors.

Radiation-induced hemorrhagic cystitis can occur both during treatment and as a delayed effect months or years later.

Bone marrow transplant

Patients who undergo a bone marrow transplantation are significantly at risk of developing hemorrhagic cystitis.

This is largely due to the high-dose chemotherapy and radiation treatment that’s commonly used to prepare an individual for the procedure.

As we’ve mentioned before, these treatments can damage the bladder’s lining, which can lead to inflammation and bleeding.

Many immunosuppressive drugs also weaken the immune system, making the body more susceptible to infections that can cause hemorrhagic cystitis.

Occupational exposure

Certain occupations that involve repeated exposure to chemicals and toxins may increase your risk of developing conditions like hemorrhagic cystitis.

Workers in the chemical manufacturing and rubber industries often work with aniline dyes, which can be harmful when inhaled or absorbed through the skin.

The following people may also have an increased risk of exposure to harmful chemicals at the workplace:

• Hairdressers and beauticians
• Painters
• Automotive industry workers
• Textile workers
• Healthcare workers handling chemotherapy drugs
• Pesticide applicators
• Agricultural workers

If you work in any of these industries, the best way to lower your risk of hemorrhagic cystitis is to use protective equipment and ensure proper ventilation where possible.

It’s also recommended to schedule regular check-ups with your doctor to ensure early detection of any medical issues.

How is Hemorrhagic Cystitis Diagnosed?

Hemorrhagic cystitis requires a professional diagnosis, and the process usually involves a combination of assessments, tests, and imaging.

The initial steps involve your doctor reviewing your medical history, including any recent infections, exposure to irritants, or treatments like chemotherapy.

Your doctor will likely ask you about your symptoms before performing a physical examination. This is when they check the abdominal and pelvic area to identify abnormalities in the bladder.

After these assessments, your doctor may request a series of tests to determine the cause of your infection. These may include:

• Urinalysis: This test checks for the presence of red and white blood cells, or other substances, in urine samples.

• Urine culture: If a bacterial infection is suspected, a urine culture can help your doctor confirm it and determine which organism is causing your lower urinary tract symptoms.

• Cytology: This involves examining a urine sample for abnormal cells and is usually used when bladder cancer is suspected.

• Blood tests: These may be performed to assess kidney function and to check for signs of infection or other related issues.

Depending on the outcome of these tests, your doctor may also recommend imaging studies to get a more detailed view of your bladder and kidneys.

Tests like an ultrasound, CT scan, MRI, or cystoscopy provide a visual image of the bladder and can help your doctor determine the severity of your infection.

If your condition is caused by a viral infection, you may need to take a PCR test to detect the presence of harmful organisms.

Once your doctor receives the results of any assessments and tests performed, they can make an accurate diagnosis and recommend an appropriate treatment method.

How Do You Treat Hemorrhagic Cystitis?

The treatment methods used for hemorrhagic cystitis vary depending on the underlying cause of the condition.

It typically involves a combination of medication, lifestyle changes, and, in severe cases, surgical intervention.

Medication

There are several types of medications that can be used to treat hemorrhagic cystitis, and it’s often the first option recommended to overcome an infection.

If the condition is caused by a bacterial infection, your doctor may prescribe antibiotics to treat it.

It’s important to complete the entire course — even if symptoms improve — to ensure that the infection is fully treated and to prevent antibiotic resistance.

In cases where hemorrhagic cystitis is caused by a virus, antiviral drugs may be used to alleviate your symptoms and help you overcome the infection.

Your doctor may also recommend over the counter (OTC) medications to help with pain management and to reduce general discomfort.

Lifestyle changes

In addition to using medication to treat hemorrhagic cystitis, certain lifestyle changes can also help alleviate your symptoms. These may include:

• Increasing your fluid intake to flush out the bladder and reduce irritation
• Avoiding foods that irritate the bladder, such as caffeine, alcohol, and spicy ingredients
• Implementing bladder-training techniques
• Avoiding smoking and nicotine products
• Avoiding exposure to known irritants, like chemicals and other pollutants
• Receiving continuous bladder irrigation if you are receiving chemotherapy

Depending on your specific lifestyle, your doctor may recommend other adjustments you can make to further reduce your risk of developing hemorrhagic cystitis. Surgery

With severe hemorrhagic cystitis cases or when traditional treatment methods are ineffective, surgery will usually be considered. Common procedures include:

• Cystoscopy clot removal: This procedure involves removing blood clots that have formed in the bladder.

• Fulguration: This involves using a laser to cauterize areas in the bladder that are bleeding uncontrollably.

• Urinary diversion: In extreme cases, a urinary diversion procedure may be necessary to prevent complications like bladder outlet obstruction. This involves creating a new way for urine to exit the body — usually through a catheter — bypassing the bladder.

It’s important to note that surgery may not be a suitable option for everyone — especially those who have underlying health conditions — and may be a risky treatment method.

Your doctor will discuss these risks with you and help you determine whether surgery is the most appropriate choice for your individual situation.

Should You See a Doctor About Hemorrhagic Cystitis?

It’s essential that you consult your doctor as soon as you suspect that you may have hemorrhagic cystitis.

This condition can cause various health complications — especially if left untreated — that can lead to further issues and reduced quality of life.

Making an appointment with your doctor allows them to:

• Detect any medical conditions early on, which helps to avoid complications
• Accurately determine the cause of your condition
• Recommend an appropriate treatment method
• Monitor you for complications
• Provide guidance on prevention strategies
• Assess your overall health and adjust treatment if necessary

It’s also recommended to see your doctor if you’re already treating a hemorrhagic cystitis infection and your symptoms aren’t improving.

This may indicate a more severe case of this condition that requires an alternative treatment method.

Where Can You Learn More About Hemorrhagic Cystitis?

If you’re concerned about your symptoms or want to know more about treating hemorrhagic cystitis, LifeMD is here to help.

LifeMD can connect you to a team of medical professionals who can assist you with information and provide guidance on managing this condition while avoiding further complications — all from the comfort of your home.

Make an appointment today to get started.