Bilateral percutaneous nephrostomy as treatment for severe hemorrhagic cystitis.

OBJECTIVE To report a case of severe hemorrhagic cystitis successfully treated by bilateral percutaneous nephrostomy. METHODS The case of a 67-year-old female patient who had monosymptomatic gross hematuria with clots is reported. RESULTS Standard conservative treatments failed and the patient developed a clot-retention plugged bladder. Endoscopic evacuation and electrocoagulation of bleeding areas was unsuccessful. Due to persistent hematuria and development of renal failure and hemodynamic instability, bilateral percutaneous nephrostomy was performed. At 24 hours, hematuria ceased, patient recovered hemodynamic stability, and no additional blood transfusions were required. CONCLUSIONS Bilateral percutaneous nephrostomy may be a valuable option for the treatment of hemorrhagic cystitis when standard conservative measures have failed and as a prior step to performance of other more invasive procedures.