title: Hyperbaric oxygen therapy for refractory radiation-induced hemorrhagic cystitis.
abstract: OBJECTIVE
  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.
authors.affiliation: Underwater and Hyperbaric Medicine Center, Portuguese Navy, Lisbon, Portugal.|Department of Urology, Hospital de Santa Maria, Lisbon, Portugal.
authors.forename: Tiago M
authors.initials: TM
authors.lastname: Ribeiro de Oliveira
authors.affiliation: Department of Urology, Hospital de Santa Maria, Lisbon, Portugal.
authors.forename: António J
authors.initials: AJ
authors.lastname: Carmelo Romão
authors.affiliation: Underwater and Hyperbaric Medicine Center, Portuguese Navy, Lisbon, Portugal.
authors.forename: Francisco M
authors.initials: FM
authors.lastname: Gamito Guerreiro
authors.affiliation: Department of Urology, Hospital de Santa Maria, Lisbon, Portugal.
authors.forename: Tomé M
authors.initials: TM
authors.lastname: Matos Lopes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D003556:Cystitis / Q000209:etiology / Q000628:therapy*; D005260:Female; D006417:Hematuria / Q000209:etiology / Q000628:therapy*; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000379:methods; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000209:etiology / Q000628:therapy*; D019233:Retreatment; D012189:Retrospective Studies; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000528:radiation effects*; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy*; D055815:Young Adult
keywords: cystitis; hematuria; hyperbaric oxygenation; proctitis; radiation injuries