Haemorrhagic cystitis (HC) can be either acute or chronic, and be caused by chemotherapeutic drugs, radiation therapy, or exposure to chemicals, such as dyes or insecticides. In transplantation settings, HC is typically associated with haematopoietic stem cell transplant (HSCT), but can also occur, albeit rarely, in solid organ recipients. It is thought that a defect in the glycosaminoglycan (GAG) layer, which coats the uroepithelium and provides the initial barrier for physiologic protection, may be the first step in its development. Once injured or defective, the GAG layer loses its barrier properties, becomes permeable, and allows the inflammatory and hypersensitisation cycle to thrive.
H Payne, A Adamson, A Bahl, J Borwell, D Dodds, C Heath, R Huddart, R McMenemin, P Patel, J Peters, , A Thompson
Chemical- and Radiation-Induced Haemorrhagic Cystitis: Current Treatments and Challenges
BJU Int 2013 Nov 01;112(7)885–897