A comprehensive retrospective analysis that spanned over a decade shed light on the incidence, risk factors and management strategies associated with radiation cystitis in prostate cancer patients who undergo pelvic radiotherapy. The findings of the study were published in the Urology journal.
The study was conducted using the extensive PearlDiver™ Mariner database and examined the records of a total of 274,865 patients who received radiotherapy for prostate cancer from 2011 and 2022. The primary objective was to determine the overall incidence of radiation cystitis and analyze the factors that contribute to its development.

The results revealed that 17.7% of patients experienced hematuria following radiotherapy, while 2.8% were diagnosed with radiation cystitis. Among the patients diagnosed, approximately 30% underwent diagnostic or therapeutic endoscopic interventions. Only a small fraction of patients, about 0.76%, opted for endovascular embolization, while 1.95% required cystectomy. Hyperbaric oxygen therapy was found to be the most prevalent treatment option that was administered to 16.67% of patients, with a significant upward trend observed over the study period.
Further analysis utilizing multivariate logistic regression unveiled several significant risk factors associated with radiation cystitis. Obesity, smoking and diabetes were identified as significant contributors with odds ratios of 1.29, 1.27 and 1.32 respectively, all with p-values below 0.001. These findings underline the importance of addressing modifiable risk factors in the management and prevention of radiation-induced complications.
The findings of this study emphasized the clinical significance of radiation cystitis as a rare yet impactful complication following pelvic radiotherapy for prostate cancer. Despite advancements in treatment modalities, the incidence of radiation cystitis remained stable throughout the study period which highlighted the need for continued research and innovative approaches to reduce its occurrence and improved patient outcomes.
The comprehensive approach of the study provides valuable insights for clinicians in risk assessment, treatment selection and patient counseling. Clinicians can tailor interventions to individual patient profiles, optimizing therapeutic efficacy and minimizing adverse effects by identifying key risk factors and evaluating management strategies. The integration of these findings into clinical practice holds the potential to enhance the overall quality of care for prostate cancer patients undergoing radiotherapy by ultimately enhancing treatment outcomes and patient well-being.
Source:
Bologna, E., Licari, L. C., Franco, A., Ditonno, F., Manfredi, C., De Nunzio, C., Antonelli, A., De Sio, M., Coogan, C., Vourganti, S., Leonardo, C., Simone, G., & Autorino, R. (2024). Incidence and Management of Radiation Cystitis After Pelvic Radiotherapy for Prostate Cancer: Analysis from a National Database. In Urology. Elsevier BV. https://doi.org/10.1016/j.urology.2024.04.035