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Review
. 2024;77(3):472-482.
doi: 10.5173/ceju.2024.116.R2. Epub 2024 Oct 28.

Safety and efficacy of non-surgical treatments for chronic post-radiation cystitis: a systematic review

Nikolaos Datseris  1 , Theodoros Gkazis  1 , Spyridon Nikas  2 , Dimitrios Memmos  3 , Eirini Zoumpanioti  4 , Petros Sountoulides  3
Affiliations
Review

Safety and efficacy of non-surgical treatments for chronic post-radiation cystitis: a systematic review

Nikolaos Datseris et al. Cent European J Urol. 2024.

Abstract

Introduction: Post-radiation cystitis is a complication of external beam radiation therapy, for the radical treatment of pelvic malignancies as radical treatment for pelvic malignancies. Chronic, refractory, post-radiation cystitis is problematic in its management, mainly when a conservative approach is preferred. Conservative methods are the first line of treatment, especially since the area has been irradiated, making surgical treatment more challenging.The objective of this systematic review is to evaluate the effectiveness and safety of conservative methods for the management of post-radiation cystitis. All non-invasive methods were included in the research, in patients over 18 years of age undergoing pelvic radiation therapy.

Material and methods: We conducted a systematic search for comparable studies on the conservative treatment of chronic post-radiation cystitis, analysing the efficacy and safety of these techniques, based on a specific protocol. The PubMed, Scopus, and CENTRAL databases and the grey literature were searched. Risk control of the individual papers was carried out using the RoB2 and ROBINS-I tools.

Results: A total of 282 papers were reviewed, of which 6 were included in the review: 3 randomised clinical trials and 3 non-randomised studies. Each of these studies investigated a different treatment, using a different population as control group, so it was not possible to conduct a meta-analysis of the studies.

Conclusions: Although most conservative measures appear to be successful in the management of post-radiation cystitis, more studies, especially randomised clinical trials, are needed before an algorithm of conservative methods can be created.

Keywords: formalin; pelvic malignancies; radiation cysticis; silver nitrate.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Papers selection process PRISMA flow diagram.
Figure 2
Figure 2
Error risk graph, using the ROB2 toll.
Figure 3
Figure 3
Total risk of error by category, using the ROB2 toll.
Figure 4
Figure 4
Error risk graph, using the ROBINS-I toll.
Figure 5
Figure 5
Total risk of error by category, using the ROBINS-I toll.
Figure 6
Figure 6
Algorithm for management of chronic post-radiation cystis based on patient symptomatology, according to Vanneste et al. [33].
Figure 7
Figure 7
Algorithm for treatment of haematuria, according to Alesawi et al. [40].
See this image and copyright information in PMC

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