• Jennifer Gardner and Emma Husbands.
• Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK. Electronic address: Jennifer.gardner15@nhs.net.
• J Pain Symptom Manage. 2024 Nov 1; 68 (5): e404e408e404-e408.

AbstractThe management of haematuria, in patients with a palliative diagnosis, refractory to standard measures presents a significant challenge for multidisciplinary teams. Our experiences with two cases led us to review the literature and highlighted the limited evidence base. We describe the cases here and propose options for medical approaches to management. We also report on successful use of a nonconjugated oestrogen which has a lower VTE risk compared to conjugated oestrogens. We aim to help support clinicians manage other palliative patients with this challenging symptom in future. Relevant references for this review were identified through searches of PubMed using the terms "haematuria," "hematuria," "palliative," "antifibrinolytic," "tranexamic acid," "etamsylate" "glucocorticoid," "oestrogen," "estrogen," "estradiol," "somatostatin," "thalidomide," hyperbaric oxygen" and "intravesical hyaluronic acid." Other references were suggested by the authors.Copyright © 2024 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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