Percutaneous nephrostomy drainage in the treatment of severe hemorrhagic cystitis

We report on 2 patients who underwent urinary diversion with bilateral percutaneous nephrostomy tube drainage for intractable hemorrhagic cystitis. Both patients received cyclophosphamide-based chemotherapy and 1 also underwent pelvic irradiation for locally advanced prostate adenocarcinoma. In each case the bleeding gradually ceased during a 1-week period. Both patients were alive at 6 months and were voiding spontaneously. We propose that the mechanism of treatment involves diverting endogenous urokinase as well as avoiding overdistention of the bladder.