Table 3.

Summary of the key studies for bladder irrigation, hyperhydration and forced diuresis and mesna in the prevention of chemical- and RT-induced cystitis

Author	Study design	Patients, n	Treatment	Incidence of HC,% (P-value)	Adverse effects, % (P-value)
Bladder irrigation
Hadjibabaie et al. (2008) [44]	Non-randomised, controlled	HSCT patients, 40	Bladder irrigation vs no bladder irrigation	32 vs 50 (NS)	UTI: 32.5 vs 20.0 (NS)
Turkeri et al. (1995) [45]	Retrospective	HSCT patients, 199	Bladder irrigation vs no bladder irrigation	23 vs 53 (<0.004)	UTI: 16.0 vs 14.0 (NS)
					Moderate to severe discomfort and bladder spasms: 6.0 (NS)
Atkinson et al. (1991) [48]	Prospective, randomised	BMT patients, 22	Bladder irrigation vs no bladder irrigation	48 vs 29*	Not reported
				52 vs 38† (NS, irrigation vs no irrigation)
Hyperhydration and forced diuresis
Trotman et al. (1999) [49]	Prospective	HSCT or BMT patients, 681	Hyperhydration and forced diuresis	HC: 18.2	Not reported
				Grade 3 or 4: 3.4
Mesna
Murphy et al. (1994) [50]	Retrospective	BMT patients, 227	Hyperhydration + mesna vs hyperhydration alone	16 vs 8 (0.08)	One patient receiving hyperhydration alone developed a bladder perforation, requiring surgical repair
Vose et al. (1993) [52]	Prospective, randomised	BMT patients, 200	Mesna vs bladder irrigation	18 vs 18 (NS)‡	UTI: 14 vs 27 (0.03)
Shepherd et al. (1991) [51]	Randomised	BMT patients, 100	Mesna vs hyperhydration	33 vs 20 (NS)	No unexpected toxicities

NS, not statistically significant.

^*Patients receiving busulfan + cyclophosphamide + RT or cyclophosphamide + RT;

^†Patients receiving busulfan + cyclophosphamide;

^‡Grade III/IV haematuria.