Efficacy of radical reconstructive surgeries in bladder hemorrhage

Despite considerable progress in recent years, medical management of bladder hemorrhage resulted from locally advanced bladder cancer, radiation-induced damages and hemorrhagic cystitis still remains a major problem. The study included 40 patients who previously received conservative and mini-invasive treatment for bladder hemorrhage, which appeared to be ineffective. Out of them, there were 22 patients who underwent radiacal cystectomy and uretherocutaneostomy and 18 patients who underwent cystectomy followed by one-or multi-stage intestinal urinary diversion according to various techniques. Results of statistical analysis showed 4 prognostic factors on the base of which the algorythm for the surgical treatment technique was suggested: age (p=0.027), pain syndrome (p=o.008), uretherohydronephrosis (p=0.038) and local tumor dissemination (for bladder cancer) (p=0.05). The 3-and 5-year recurrence-free survival rates were 55.8%) and 47.8%, respectively. The overall survival rates were 71.2% and 58.0%, respectively. The 3-and 5-year survival rates were 61.4% for patients with intestinal urinary derivation, while the 3-year survival rate was 39.2% and the 5-year survival rate was not determined for patients with uretherocutaneoustomy.