More than half of emergency department visits for radiation cystitis (RC) as a complication of radiation therapy (RT) in men with a history of prostate cancer result in invasive procedures for treatment, according to investigators.
“While RT remains an effective treatment for patients with prostate cancer, providers should be mindful of RC as a potential complication, as severe cases could lead to significant bleeding or anaemia,” Vikram Jairam, MD, of the Yale School of Medicine in New Haven, Connecticut, and colleagues concluded in BJU International. “Patients at greatest risk of this complication should be monitored closely in the outpatient setting.”
In a study of data from the Nationwide Emergency Department Sample from January 2006 to December 2015, invasive procedures, mostly transurethral excision, were required in 9655 (55.5%) of 17,382 RC-related emergency department visits made by men with a history of prostate cancer, the investigators reported.
Prior prostatectomy, urinary retention, hematuria, and blood transfusion were significantly associated with a 5.5-, 1.4-, 1.2-, and 2.1-fold increased odds for undergoing an invasive procedure, according to Dr Jairam and colleagues. Factors not associated with invasive procedures included metastatic cancer and long-term anticoagulation.
ED visits with invasive procedures had a higher median total charge compared with visits without invasive procedures ($34,707.53 vs $15,632.53) and an increased length of stay (5 vs 3 days).
Lee V, An Y, Park HS, Yu JB, Kim SP, Jairam V. Emergency department visits for radiation cystitis among patients with a prostate cancer history. BJU Int. Published online November 22, 2021. doi:10.1111/bju.15650