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.

CONCLUSION: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.

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.