title: Hyperbaric oxygen-A new horizon in treating cyclophosphamide-induced hemorrhagic cystitis.
abstract: Hemorrhagic cystitis consists of acute or insidious diffuse bleeding from the bladder mucosa. It can be caused by radiation, drugs, autoimmune diseases, viral and bacterial infections, etc. Hemorrhagic cystitis is a well-recognized complication of cyclophosphamide therapy and it can be potentially fatal. We discuss two cases of cyclophosphamide-induced hemorrhagic cystitis where outcome of conventional management was not satisfactory and a novel therapy using hyperbaric oxygen was used. Hyperbaric oxygen therapy (HBOT) reduces inflammation, stimulates neoangiogenesis, maintains tissue oxygenation and heals tissue hypoxia and radio necrosis. Patients received 100% oxygen in a hyperbaric chamber at 2.5 atmosphere absolute (ATA) for 90 minutes, 5 days a week. One patient was given 36 sessions and the other was given 19 sessions of HBOT. HBOT resulted in complete cessation of bleeding; no side effect was noted during the course of therapy. There was no relapse after 12 months of cessation of treatment. In future, this form of therapy can offer a safe alternative in the treatment of cyclophosphamide-induced hemorrhagic cystitis.
authors.affiliation: Department of Internal Medicine, Medical College, Trivandrum, India.
authors.forename: S
authors.initials: S
authors.lastname: Ajith Kumar
authors.forename: P
authors.initials: P
authors.lastname: Prasanth
authors.forename: Kk
authors.initials: K
authors.lastname: Tripathi
authors.forename: Pc
authors.initials: P
authors.lastname: Ghosh