Hemophilia A presenting unusual vesical bleeding; report of a case

A 43-year-old man with moderate hemophilia A developed vesical bleeding hard to control. The cause of hemorrhage was found to be an infiltrating cancer of the bladder, histology of which was undifferentiated carcinoma with focal transitional carcinoma interestingly in the muscular layer. Malignant alteration in this case was thought to be induced by mechanical stimulation such as frequent fulguration, cystotomy, and long-term catheter indwelling. Recently, major surgery on hemophiliacs has become much safer by replacement of the deficient factor. Besides transfusion of fresh blood and frozen plasma, various type of factor VIn preparations have made the pre-and postoperative management easier and greatly improved the operative results. Cryoprecipitate of our own make gave the good result in maintaining the antihemophilic factor level.