title: Hyperbaric oxygen therapy (HBOT) in case of hemorrhagic cystitis after radiotherapy.
abstract: BACKGROUND
  We present the effect of hyperbaric oxygen therapy (HBOT) after radiotherapy for cancer in the pelvic cavity resulting in hematuria. Increasing the pressure of oxygen (PO2) in ischemic tissues favors the formation of new blood vessels and increases the secretion of collagen.
  
  
  METHODS
  We evaluated 10 patients who were treated with HBOT from October 2006 to December 2010 due to persistent radiation damage to the lining of the bladder leading to recurrent hematuria. The study group was comprised of seven men and three women. In the case of cervical and endometrial cancers, 30 Gy of brachytherapy with 45-50 Gy of teleradiotherapy were used. In prostate cancer (PCa), we applied 50 Gy of teleradiotherapy with an additional dose of 20-24 Gy, and in the case of bladder cancer (BCa), 50 Gy of teleradiotherapy was applied with an additional dose of 16 Gy. HBOT consisted of 60 HBO2 treatments, in which patients were administered 100% oxygen at a pressure of 2.5 atm.
  
  
  RESULTS
  The group effect of total or partial resolution was observed in six patients. In one case, treatment was discontinued due to an increase in hematuria and the consequent suspicion of bladder tumor recurrence. While in and additional three cases, the treatment did not produce the desired result.
  
  
  CONCLUSIONS
  Treatment of hemorrhagic cystitis is a difficult therapeutic challenge. One possible method is the implementation of HBOT. In very difficult cases, HBO2 treatment appears to be effective in giving more than half of patients a chance of getting better.
authors.affiliation: Department of Urology, Medical University of Gdańsk, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Polom
authors.affiliation: Department of Hyperbaric Medicine and Sea Rescue - University Center for Maritime and Tropical Medicine in Gdynia, National Center for Hyperbaric Medicine, Gdynia, Poland.
authors.forename: Alicja
authors.initials: A
authors.lastname: Klejnotowska
authors.affiliation: Department of Urology, Medical University of Gdańsk, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Matuszewski
authors.affiliation: Department of Hyperbaric Medicine and Sea Rescue - University Center for Maritime and Tropical Medicine in Gdynia, National Center for Hyperbaric Medicine, Gdynia, Poland.
authors.forename: Zdzislaw
authors.initials: Z
authors.lastname: Sicko
authors.affiliation: Department of Urology, Medical University of Gdańsk, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Markuszewski
authors.affiliation: Department of Urology, Medical University of Gdańsk, Poland.
authors.forename: Kazimierz
authors.initials: K
authors.lastname: Krajka
keywords: bladder cancer; hematuria; hemorrhagic cystitis; hyperbaric oxygen therapy; radiotherapy