Medical Treatment of Hematuria Due to Bladder Hemangioma in a Newborn

Excerpt

To the Editor: Although hemangiomas are the most common benign tumors of infancy, they are extremely rare in urinary bladder and account for 0.6% of bladder tumors [1]. We report a 7-d-old male newborn with multiple bladder capillary hemangiomas successfully treated with propranolol and intravesical corticosteroid. Although routine biochemical analyses, complete blood count, coagulation parameters and acute phase reactants were normal, urinalysis showed abundant red blood cells exhibiting a normal morphology per high-power field. Renal doppler, renal and urinary tract ultrasonography were normal. Urine culture showed no growth. Urine calcium:creatinine and uric acid:creatinine ratio were normal. Cystoscopic examination showed multiple reddish sessile capillary hemangiomas of variable sizes from 0.5 cm to 1.5 cm on the bladder dome. We treated the patient with propranolol beginning dose of 0.5 mg/kg/d in three divided doses for the first 24 h, and then it was gradually increased to 2 mg/kg/d in three divided doses for 5 wk, also 10 mg prednisolone plus 20 ml saline was given into the bladder for irrigation via a Foley catheter, and to catheter was clamped for 20 min and then was opened everyday for 10 d. No side effects were noted and hematuria was completely resolved at the fifth day of therapy. Control cystoscopic examination was performed after five weeks and it was normal. Hematuria episode has not been detected during the follow-up period of 12 mo. …