Discussion
In both cases described, a single local application of CSP improved clinical signs of haematuria in 24 to 48 hours in the absence of any relevant adverse effect. The powder used is a 5-gram biocompatible non-pyrogenic non-toxic second-generation starch product with significant water absorption capacity (64 ml/2 g powder) and with reported complete absorption within 48-72 hours. The product used is available off-the-shelf and does not require further preparations or specific storage. Its mechanism of action is based on the uptake of the water component of the blood, which concentrates blood cells (platelets, serum proteins and blood cells) in a gelled adhesive matrix that accelerates the clotting cascade and also acts as a mechanical barrier that limits further bleeding (Bruckner et al.2021). To date, no serious side effects are reported in association with the use of SH powder (migration, foreign body reactions, compression and damage of tissues) (Schmitz and Sodian 2015). Its vegetal nature is thought to decrease the risk of allergic reactions compared to animal matrices (Vecchio et al. 2016).