Evaluation of Hyperbaric Oxygen Therapy in the Treatment of Radiation-Induced Haemorrhagic Cystitis

OBJECTIVE - To evaluate the efficacy of hyperbaric oxygen therapy (HBO) in the treatment of post-radiation haematuria (PRH) and to identify the predictive factors for a successful outcome.

MATERIALS AND METHODS - We conducted a retrospective study and included all patients treated with HBO for PRH in a university hospital centre between January 2003 and December 2013.

We studied the patients' clinical characteristics, radiotherapy indication, treatments preceding HBO, the grade of haematuria diagnosed based on the CTCAE classification v 4.03 and the efficacy of HBO. The success of HBO was defined as the total or partial resolution of haematuria.

RESULTS - We included 71 patients with a median age of 72 (39-87) years. PRHs were severe (grade≥3) in 50 (70.4%) of the cases. Radiotherapy was indicated in the treatment of prostate cancer in 61 (85.9%) patients. The median length of time between haematuria and HBO was 8 (1-154) months. Prior to HBO, 46 (64.8%) patients underwent electrocoagulation of the bladder. HBO sessions were compounded by 9 cases of barotraumatic otitis, 5 cases of transient visual disturbance, and one case of finger paresthesia. On average, 29 (3-50) sessions were carried out. Treatment was effective in 46 (64.8%) patients, 37 (52.1%) of whom were completely cured. A haematuria grade of less than 3 was a predictive factor in successful treatment (p=0.027). Median follow-up was 15 (1-132) months.

CONCLUSIONS - Hyperbaric oxygen therapy completely resolves post-radiation haematuria in 52.1% of cases. Prolonged patient follow-up is required in order to confirm the efficacy of this treatment.

Urology. 2016 Apr 25 [Epub ahead of print]

Julien Mougin, Vincent Souday, François Martin, Abdel Rahmène Azzouzi, Pierre Bigot

Department of Urology, Angers University Hospital, France., Department of medical intensive care and hyperbaric medicine, Angers University Hospital, France., Department of Urology, Angers University Hospital, France., Department of Urology, Angers University Hospital, France., Department of Urology, Angers University Hospital, France.  

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