What is a common cause of hemorrhagic cystitis in patients undergoing chemotherapy?

Hemorrhagic cystitis is a complication often seen in patients undergoing chemotherapy, particularly due to the use of certain alkylating agents like cyclophosphamide. Cyclophosphamide is metabolized in the liver to produce acrolein, a toxic metabolite that can irritate the bladder mucosa and lead to inflammation and bleeding. This toxicity is a well-documented adverse effect of cyclophosphamide, making it a significant concern for clinicians managing patients receiving this medication.

Patients receiving cyclophosphamide may present with symptoms such as hematuria (blood in the urine), dysuria (painful urination), and increased urinary frequency. The use of hydration and co-administration of mesna, a protective agent that binds to acrolein, can help mitigate the risk of developing hemorrhagic cystitis in these patients.

While radiation therapy can cause cystitis as well, it typically involves a different pathophysiological mechanism and is not as directly linked to hemorrhagic cystitis resulting from chemotherapeutic agents. Urinary tract infections can cause cystitis, but they do not inherently lead to the hemorrhagic type seen with cyclophosphamide. Dehydration might contribute to urinary complications, but it is not a direct