Posted by CLDing on February 24, 1998 at 10:47:57:
In Reply to: Re: Radiation Cystitis and Stones posted by C S Loh on February 23, 1998 at 10:58:32:
Any information on behaviour of irradiated tissue to ESWL - if we do in ESWL in situ
for the distal stone?
Finding this lady's u.o. is going to be tricky leave alone dilating it. Her bladder is
slightly bigger than a thimble now but does not hold any urine!!
Why Prednisolone - I use a short burst of steroids (usually dexamethasone) in cases of
radiation cystitis who presents with blown up upper tracts, assuming that there is severe
oedema causing obstruction. I have found it very helpful in managing patients with
radiation injuries to the pelvis - whether acutely or when they present with exacerbations
many years later. Try it some day - when you see the tell tale sign of thick indurated
skin and subcut. fat in the pelvis which was not there previously. Indeed in this lady,
both the hydronephrosis settled gradually over 3 weeks (I monitored her with USS as her
creatinine was initially elevated). I did an IVU only when the right sided hydronephrosis
failed to resolve when the left one had completely done so after 2 weeks.