Hyperbaric oxygen therapy for refractory radiation-induced hemorrhagic cystitis

Objectives: To analyze the efficacy of hyperbaric oxygen for the treatment ofradiation-induced hemorrhagic cystitis and to identify factors associated with successfultreatment.Methods: Clinical records from 176 patients with refractory radiation-inducedhemorrhagic cystitis treated at the Portuguese Navy Center for Underwater andHyperbaric Medicine, during a 15-year period, were retrospectively analyzed. Evolutionof macroscopic hematuria was used to analyze treatment efficacy and correlated withother external variables.Results: From a total of 176 treated patients, 23.9% evidenced other radiation-inducedsoft tissue lesions. After an average on 37 sessions, 89.8% of patients showed resolutionof hematuria, with only 1.7% of adverse events. In our sample, hematuria resolution aftertreatment with hyperbaric oxygen was statistically associated to the need for transfusiontherapy (P = 0.026) and the number of sessions of hyperbaric oxygen (P = 0.042). Norelationship was found with the remaining variables.Conclusions: Refractory radiation-induced hemorrhagic cystitis can be successfully andsafely treated with hyperbaric oxygen. Treatment effectiveness seems to be correlatedwith the need for transfusion therapy and the number of sessions performed