title: Hyperbaric oxygen therapy for the management of hemorrhagic radio-induced cystitis.
abstract: OBJECTIVE
  Radio-induced cystitis (RADC) is an inflammatory bladder disease that presents as anemic-hematuria in its most  serious form. Classic treatments can not control the disease in the mid-to-long term because they don't treat the pathogenesis  of the disease. Thus, we evaluated the effectiveness of hyperbaric oxygen (HBO) therapy as a potential treatment for patients with RADC.
  
  
  METHODS
  This prospective study included 38 patients, 21 men and 17 women, mean age of 66.5 years(46-75), who had been subjected to pelvic  radiotherapy (RT), with the diagnosis of RADC with or without radio-induced proctitis (RADP), gross hematuria and lower urinary tract symptoms. HBO treatment was applied in a multiplace chamber; patients breathed pure oxygen (100%) at 2-2.5  atmospheres  of pressure (ATAs). Patients received an average of 31.2 sessions (10-48 sessions) and the median follow-up period  was 56 months (4-72 months).
  
  
  RESULTS
  Hematuria was completely resolved in 34 of the 38 patients. After HBO 6 patients required readmission, 5 for anemic hematuria and 1 for acute  obstructive pyelonephritis. In general, patients tolerated treatment well; however, one patient experienced barotrauma requiring myringotomy.
  
  
  CONCLUSIONS
  HBO can be used to satisfactorily treat RADC, leading to clinical improvements that begin during the initial sessions in the majority of  cases, and with a more than acceptable level of patient tolerance.
authors.affiliation: Urology Department, Hospital General de Castellón, Castellón de la Plana, Spain. dagalvi@hotmail.com
authors.forename: Daniel Gallego
authors.initials: DG
authors.lastname: Vilar
authors.forename: Gonzalo García
authors.initials: GG
authors.lastname: Fadrique
authors.forename: Ivan José Povo
authors.initials: IJ
authors.lastname: Martín
authors.forename: Jaume Miralles
authors.initials: JM
authors.lastname: Aguado
authors.forename: Carmen Garau
authors.initials: CG
authors.lastname: Perelló
authors.forename: Vicente Gimeno
authors.initials: VG
authors.lastname: Argente
authors.forename: Manuel Bosquet
authors.initials: MB
authors.lastname: Sanz
authors.forename: Juan Galego
authors.initials: JG
authors.lastname: Gómez
mesh_terms: D000368:Aged; D003556:Cystitis / Q000209:etiology / Q000628:therapy*; D005260:Female; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011832:Radiation Injuries / Q000150:complications / Q000628:therapy*