Urinary bladder outcome

Like cyclophosphamide, ifosfamide causes a hemorrhagic cystitis in a high proportion of patients, with an occasionally fatal outcome. The damage to urinary bladder epithelium is caused by acrolein, a metabolite that is excreted in the urine. In bone marrow transplant recipients, prior administration of busulfan, which itself causes hemorrhagic cystitis, can increase this risk of oxazaphosphorines (12). Mesna (sodium... 

Methemoglobin formation was considered the most serious health outcome following exposure to 2NA until the increased rate of urinary bladder tumors were confirmed in the workers. Methemoglobinemia is symptom-less until acutely toxic. In one report workers exposed to 2NA were required to pass through the medical department following their shift so that any cyanosis could be ascertained. 

Stenzl A, Penkoff H, Daje-Sommerer E, Zumbraegel A, Hoeltl L, Scholz M, Riedl C, Bugelnig J, Hobisch A, Burger M, Mikuz G, Pichlmeier U. Detection and clinical outcome of urinary bladder cancer with 5-aminolevulinic acid-induced fluorescence cystoscopy a multicenter randomized, double-blind, placebo-controlled trial. Cancer 2011 117(5) 938 7. 

The proposed reason for cardiovascular arrest in this case was urinary syncope, which can follow rapid loss of tension in the bladder. Care has to be taken to avoid rapid emptying of a distended bladder, although the fatal outcome is difficult to understand. 

Nonneurogenic bladder-sphincter dysfunction in patients with renal transplantation may have a negative effect on the transplanted kidney (Van der Weide et al. 2006 Luke et al. 2003 Adams et al. 2004). In a study by Luke et al. (2003) comparing the long-term outcomes of graft survival between children with dysfunctional lower urinary tract and children with a normal lower urinary tract, it was found that lower urinary tract pressure plays an important role in graft survival. 

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