Real-world insights into hemorrhagic cystitis

An etiology-specific examination of healthcare utilization patterns and patient outcomes

Authors

  • Sri Saran Manivasagam Penn State Health Milton S Hershey Medical Center
  • Blake R. Baer Pennsylvania State University College of Medicine
  • Jay D. Raman Pennsylvania State University College of Medicine
  • Roderick Clark Pennsylvania State University College of Medicine

DOI:

https://doi.org/10.5489/cuaj.9624

Keywords:

hemorrhagic cystitis, healthcare utilization, Radiation-induced cystitis, Chemotherapy complications, Infection-related cystitis

Abstract

Introduction: Hemorrhagic cystitis (HC) is a clinically significant condition with diverse etiologies, yet data on its healthcare burden remain limited. This study aimed to evaluate the healthcare utilization patterns and outcomes associated with HC across multiple etiologies.

Methods: We conducted a retrospective cohort analysis using the TriNetX database, identifying 177 947 patients diagnosed with HC over a 20-year period. Patients were stratified into four etiologic cohorts: radiation-induced, infection-induced, chemotherapy-related, and systemic disease-related. Outcomes included emergency department (ED) visits, repeat visits to the ED, hospital admissions, procedural interventions, and mortality rates at seven days, 30 days and 90 days. Demographic profiles and comorbidity profiles were also assessed.

Results: In this cohort study of HC patients, demographics and clinical characteristics varied by etiology. Radiation-induced HC patients were oldest (mean age 69.8 years), while infection-induced HC had the highest Hispanic/Latino (8.4%) and Black (18.6%) representation. Systemic autoimmune HC showed the highest comorbidity burden. ED presentations were most frequent in infection-induced HC (47.7%), while chemotherapy-induced HC had the highest admission (60% at 30 days and 64.4% at 90 days) and 90-day mortality (11.9%). Radiation-induced HC had the highest procedural rates across all time points (42.3%, 48.9%, and 54.6% at seven days, 30 days, and 90 days, respectively).

Conclusions: This study provides a comprehensive characterization of HC across etiologies, highlighting underrecognized subgroups with significant healthcare impact. Findings underscore the need for standardized treatment protocols to enhance clinical management.

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Published

2026-09-25

How to Cite

Manivasagam, S. S., Baer, B. R., Raman, J. D., & Clark, R. (2026). Real-world insights into hemorrhagic cystitis: An etiology-specific examination of healthcare utilization patterns and patient outcomes. Canadian Urological Association Journal, 21(1). https://doi.org/10.5489/cuaj.9624

Issue

Vol. 21 No. 1 (2027): CUAJ January

Section

Original Research

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