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Chapter 40 - Hematuria

Published online by Cambridge University Press:  24 April 2026

Angela Bray Lindsay
Affiliation:
Virginia Commonwealth University
Monica Kathleen Wattana
Affiliation:
University of Texas, MD Anderson Cancer Center
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Summary

1. Hemorrhagic cystitis (HC) is a condition characterized by inflammation and bleeding of the bladder lining.

2. It is important to have a high index of suspicion for HC in patients who complain of urinary changes after starting chemotherapy or who have previously undergone pelvic radiation therapy.

3. Symptoms commonly include blood in the urine, increased urinary frequency and urgency, pain with urination and lower abdominal pain.

4. HC can present as mild non-infectious hematuria, but in more severe cases as gross hematuria with hemorrhage and clots causing acute urinary retention.

5. The best treatment is prevention and supportive care with saline diuresis and mesna.

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