Hyperbaric oxygen therapy for refractory radiation-induced hemorrhagic cystitis

Int J Urol. 2015 Oct;22(10):962-6. doi: 10.1111/iju.12857. Epub 2015 Jul 5.


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.

Keywords: cystitis; hematuria; hyperbaric oxygenation; proctitis; radiation injuries.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Transfusion
  • Cystitis / etiology
  • Cystitis / therapy*
  • Female
  • Hematuria / etiology
  • Hematuria / therapy*
  • Humans
  • Hyperbaric Oxygenation* / methods
  • Male
  • Middle Aged
  • Prostatic Neoplasms / radiotherapy*
  • Radiation Injuries / etiology
  • Radiation Injuries / therapy*
  • Retreatment
  • Retrospective Studies
  • Treatment Outcome
  • Urinary Bladder / radiation effects*
  • Uterine Cervical Neoplasms / radiotherapy*
  • Young Adult