Hyperbaric oxygen therapy for refractory radiation-induced hemorrhagic cystitis

Tiago M Ribeiro de Oliveira, António J Carmelo Romão, Francisco M Gamito Guerreiro, Tomé M Matos Lopes
International Journal of Urology: Official Journal of the Japanese Urological Association 2015, 22 (10): 962-6

OBJECTIVES: To analyze the efficacy of hyperbaric oxygen for the treatment of radiation-induced hemorrhagic cystitis and to identify factors associated with successful treatment.

METHODS: Clinical records from 176 patients with refractory radiation-induced hemorrhagic cystitis treated at the Portuguese Navy Center for Underwater and Hyperbaric Medicine, during a 15-year period, were retrospectively analyzed. Evolution of macroscopic hematuria was used to analyze treatment efficacy and correlated with other external variables.

RESULTS: From a total of 176 treated patients, 23.9% evidenced other radiation-induced soft tissue lesions. After an average on 37 sessions, 89.8% of patients showed resolution of hematuria, with only 1.7% of adverse events. In our sample, hematuria resolution after treatment with hyperbaric oxygen was statistically associated to the need for transfusion therapy (P = 0.026) and the number of sessions of hyperbaric oxygen (P = 0.042). No relationship was found with the remaining variables.

CONCLUSIONS: Refractory radiation-induced hemorrhagic cystitis can be successfully and safely treated with hyperbaric oxygen. Treatment effectiveness seems to be correlated with the need for transfusion therapy and the number of sessions performed.

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