Significance of Urological Surgical Treatment for Viral Hemorrhagic Cystitis after Allogeneic Hematopoietic Stem Cell Transplantation
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- Kurosawa Kazuhiro
- The Department of Urology, Toranomon Hospital
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- Urakami Shinji
- The Department of Urology, Toranomon Hospital
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- Ishiwata Kazuya
- The Department of Hematology, Toranomon Hospital
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- Miyagawa Jinpei
- The Department of Urology, Toranomon Hospital
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- Sakaguchi Kazushige
- The Department of Urology, Toranomon Hospital
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- Fujioka Masashi
- The Department of Urology, Toranomon Hospital
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- Murata Hirokatsu
- The Department of Urology, Toranomon Hospital
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- Inoshita Naoko
- The Department of Diagnostic Pathology, Toranomon Hospital
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- Taniguchi Shuichi
- The Department of Hematology, Toranomon Hospital
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- Okaneya Toshikazu
- The Department of Urology, Toranomon Hospital
Bibliographic Information
- Other Title
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- 同種造血幹細胞移植後のウイルス性出血性膀胱炎に対する泌尿器科的外科治療の意義
- ドウシュ ゾウケツ カンサイボウ イショク ゴ ノ ウイルスセイ シュッケツセイ ボウコウエン ニ タイスル ヒニョウキカテキ ゲカ チリョウ ノ イギ
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Abstract
This study investigated the significance of urological surgical intervention for viral hemorrhagic cystitis (HC) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). A total of 1, 024 patients underwent allo-HSCT at our medical center between January 2006 and July 2014. In the 6 patients (0.58%) who required urological surgical treatment for viral HC, we retrospectively analyzed patient characteristics and outcomes. Two patients underwent nephrostomy for bilateral hydronephrosis due to bladder tamponade. One of these patients showed no improvement in renal function, graft versus host disease worsened and he died on postoperative day (POD) 5. The other patient displayed improved renal function but hematuria did not improve, and total cystectomy was required. To control bleeding, we performed transurethral electrocoagulation (TUC) on 3 patients, and total cystectomy was performed on 2 patients. All 3 patients who underwent TUC had BK virus HC. Two of these patients experienced marked improvement in hematuria from immediately after surgery. Hemostasis was only temporary in the other patient, who eventually died due to septicemia on POD 24. The 2 patients who underwent total cystectomy had adenovirus HC. Both experienced secondary hemorrhage postoperatively and required further surgery. Eventually, one died due to postoperative bleeding on POD 1, and one died due to postoperative pneumonia on POD 57. Urological surgical treatment for HC was effective in some cases, but the ultimate outcome greatly depends on the general condition of the patient and treatment of the underlying hematological disorder. TUC may be considered for HC (particularly BK virus HC), but total cystectomy (especially inaden ovirus HC) should be avoided.
Journal
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- 泌尿器科紀要
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泌尿器科紀要 62 (11), 563-567, 2016-11-30
泌尿器科紀要刊行会
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Details 詳細情報について
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- CRID
- 1390290699820598528
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- NII Article ID
- 120005895428
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- NII Book ID
- AN00208315
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- HANDLE
- 2433/217590
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- NDL BIB ID
- 027752101
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- ISSN
- 00181994
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- PubMed
- 27919133
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- Text Lang
- ja
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- Data Source
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- JaLC
- IRDB
- NDL
- PubMed
- CiNii Articles
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- Abstract License Flag
- Allowed