Cutaneous vesicostomy with direct intravesical application of formalin: Management of severe vesical hemorrhage resulting from high dose cyclophosphamide in boys

A severe form of hemorrhagic cystitis occurs when high doses of cyclophosphamide are administered before bone marrow transplantation. Severe vesical bleeding in male children is difficult to manage because the small urethra precludes the use of large catheters for bladder irrigation and clot removal. We report on the use of cutaneous vesicostomy with the instillation of 4% formalin to control bleeding in 3 boys.