Is treatment of hemorrhagic radiation cystitis with hyperbaric oxygen effective?

Objective: We report our own experience with the use of hyperbaric oxygen (HBO) for the management of postradiation hemorrhagic cystitis.

Methods: We reviewed retrospectively 14 patients from 2001 to 2007 with different pelvic organ malignancies who developed radiation cystitis after irradiation. Patients received 100% oxygen in a hyperbaric chamber at a pressure of 2.5 atmospheres absolute, 60 min bottom time, once a day, 7 days a week for at least 1 month. In principle, 30 HBO treatments per course were performed. After every course of HBO treatments, therapeutic effect was evaluated. The mean duration of follow-up of all patients was 18 months (range: 1-6 years).

Results: Patients were divided into 2 groups, group 1 (treatment group, n = 10) and group 2 (without treatment, n = 4). The mean duration between the onset of hematuria and the beginning of HBO therapy was 8.9 months (range: 3-34). Group 2 did not receive HBO because they were not healthy enough. Only 2 patients (20%) of group 1 recovered from their hemorrhagic cystitis. Group 1 had a significantly lower cure rate of postirradiation hemorrhagic cystitis in comparison to group 2.

Conclusions: Our experience with the use of HBO did not yield favorable results. Randomized well-controlled studies are needed.