Management of postoperative radiation injury of the urinary bladder by hyperbaric oxygen (HBO).
OBJECTIVE
In many case reports the success of treatment of late complications of radiotherapy with hyperbaric oxygenation (HBO) has been shown. This synopsis attempts to review HBO in the treatment of chronic radiation injury of the bladder.


METHODS
Three female patients who had developed urge-incontinence after a Wertheim operation and combined brachy-teletherapy with cobalt-60 and afterloading and did not respond to various drug therapies, were treated with HBO to a maximum of 40 applications.


RESULTS
In all patients HBO altered and inverted the dynamic process underlying chronic bladder changes after irradiation. Rationales for the HBO are the reduction of tissue hypoxia and the induction of neoangiogenesis.


CONCLUSIONS
There are no prospective trials up to date showing the benefit of HBO to urinary disorders caused by radiation cystitis. The positive results of our retrospective study should encourage clinicians to initiate prospective studies with the use of HBO in the treatment of radiation cystitis.
Peusch-Dreyer
D
D
Zentrum für Tauch- und Uberdruckmedizin-ZETUM, Bremen. hbobremen@aol.com
Dreyer
K H
KH
Müller
C D
CD
Carl
U
U
D001918:Brachytherapy / Q000009:adverse effects*; D003037:Cobalt Radioisotopes / Q000009:adverse effects; D003131:Combined Modality Therapy / Q000009:adverse effects; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation; D007044:Hysterectomy; D011832:Radiation Injuries / Q000209:etiology / Q000628:therapy*; D011878:Radiotherapy / Q000009:adverse effects*; D012189:Retrospective Studies; D001743:Urinary Bladder / Q000503:physiopathology / Q000528:radiation effects*; D014549:Urinary Incontinence / Q000209:etiology / Q000628:therapy*
D003037:Cobalt Radioisotopes