The Use of Hyperbaric Oxygen in Urology

Capelli-Schellpfeffer, Mary; Gerber, Glenn S.

doi:10.1097/00005392-199909010-00002

Cited by 98 publications

(66 citation statements)

References 57 publications

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“…Telangiectasia, submucosal haemorrhage and interstitial fibrosis follow. Obliterative endarteritis of small blood vessels leads to acute and chronic ischemia of the bladder wall and eventually to smooth muscle fibrosis due to cellular hypoxia (22). Hyperbaria related to HBO therapy increases bladder's tissue oxygen tension (14).…”

Section: Discussionmentioning

confidence: 99%

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Is there a role for hyberbaric oxygen as primary treatment for grade IV radiation-induced haemorrhagic cystitis? a prospective pilot-feasibility study and review of literature

et al. 2014

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ARTICLE INFO ______________________________________________________________ ______________________Purpose: To examine the safety and efficacy of hyperbaric oxygen as the primary treatment for Grade IV radiation-induced haemorrhagic cystitis. Materials and Methods:Hyperbaric oxygen was prospectively applied as a primary treatment option in 11 patients with Grade IV radiation cystitis. Primary endpoint was the incidence of complete and partial response to treatment. Secondary endpoints included the duration of response, the correlation of treatment success-rate to the interval between the onset of haematuria and initiation of therapy, blood transfusion need and total radiation dose, the number of sessions to success, the avoidance of surgery and the overall survival.Results: All patients completed therapy without complications for a mean follow-up of 17.82 months (range 3 to 34). Mean number of sessions needed was 32.8 (range 27 to 44). Complete and partial response rate was 81.8% and 18.2%, respectively. However, in three patients the first treatment session was not either sufficient or durable giving a 72.7% rate of durable effect. Interestingly, all 9 patients with complete response received therapy within 6 months of the haematuria onset compared to the two patients with partial response who received therapy at 8 and 10 months from the haematuria onset, respectively (p = 0.018). The need for blood transfusion (p = 0.491) and the total radiation dose (p = 0.259) were not correlated to success-rate. One patient needed cystectomy, while all patients were alive at the end of follow-up. Conclusions: Early primary use of hyperbaric oxygen to treat radiation-induced grade IV cystitis is an effective and safe treatment option.

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Section: Discussionmentioning

confidence: 99%

“…Vasoconstriction and cease of bleeding and improvements of tissue healing and immune function constitute ad-ditional beneficial effects of HBO (6,12,(15)(16)(17). For these reasons, HBO is the only treatment which is believed to reverse the vascular radiation-induced pathophysiology (15,22).…”

Section: Discussionmentioning

confidence: 99%

Is there a role for hyberbaric oxygen as primary treatment for grade IV radiation-induced haemorrhagic cystitis? a prospective pilot-feasibility study and review of literature

et al. 2014

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“…Adverse events, including visual disturbance, Eustachian tube dysfunction and claustrophobia are unusual. 15 Furthermore, the advantage of HBO is non-invasive nature compared with hydrodistension 13 or intravesical instillation of dimethylsulfoxide (DMSO). 16 The present two cases suggest that HBO could be used for treatment of IC patients resistant to conventional therapies.…”

Section: Discussionmentioning

confidence: 99%

Hyperbaric oxygen therapy for interstitial cystitis resistant to conventional treatments

Tanaka¹,

Kawashima²,

Makino³

et al. 2007

Int J of Urology

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Abstract:We treated two cases of interstitial cystitis (IC) that were resistant to some conventional therapies with hyperbaric oxygen (HBO). Both patients underwent 20 sessions of 100% oxygen inhalation (2.0 atmosphere absolute for 60 min/day ¥ 5 days/week for 4 weeks) in a hyperbaric chamber. The period of follow up was 12 months for case 1 and 9 months for case 2. After a course of HBO, the bladder mucosal ulcer (Hunner's ulcer) disappeared , and changes from baseline in pain and urinary frequency was constitutively inhibited. There were no adverse events during the 20 treatment sessions. One woman (case 1) had mild Eustachian tube dysfunction, resulting in a transient hearing impairment. HBO seems to be an option for treatment of IC resistant to conventional therapies.

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“…The hyperbaric chamber provides conditions under which hemoglobin is fully saturated and oxygen is dissolved at very high concentrations in the blood plasma, which is then circulated to provide therapeutic benefits-such as increased angiogenesis and fibroblast activity 46 -in damaged tissues. Thus, it can be considered as an alternative treatment for patients with an underlying ischemic process that is unresponsive to conventional therapy.…”

Section: Hyperbaric Oxygen Therapymentioning

confidence: 99%

“…Serious complications, such as oxygen toxicity, are very rare. 46 The reported success rate of HBOT for radiation cystitis varies from 60% to 92% (Table 4). These results are highly in favor of this treatment option for refractory radiation-induced hemorrhagic cystitis.…”

Section: Hyperbaric Oxygen Therapymentioning

confidence: 99%

Management of radiation cystitis

2010

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Acute radiation cystitis occurs during or soon after radiation treatment. It is usually self-limiting, and is generally managed conservatively. Late radiation cystitis, on the other hand, can develop from 6 months to 20 years after radiation therapy. The main presenting symptom is hematuria, which may vary from mild to severe, life-threatening hemorrhage. Initial management includes intravenous fluid replacement, blood transfusion if indicated and transurethral catheterization with bladder washout and irrigation. Oral or parenteral agents that can be used to control hematuria include conjugated estrogens, pentosan polysulfate or WF10. Cystoscopy with laser fulguration or electrocoagulation of bleeding points is sometimes effective. Injection of botulinum toxin A in the bladder wall may relieve irritative bladder symptoms. Intravesical instillation of aluminum, placental extract, prostaglandins or formalin can also be effective. More-aggressive treatment options include selective embolization or ligation of the internal iliac arteries. Surgical options include urinary diversion by percutaneous nephrostomy or intestinal conduit, with or without cystectomy. Hyperbaric oxygen therapy (HBOT) involves the administration of 100% oxygen at higher than atmospheric pressure. The reported success rate of HBOT for radiation cystitis varies from 60% to 92%. An important multicenter, doubleblind, randomized, sham-controlled trial to evaluate the effectiveness of HBOT for refractory radiation cystitis is currently being conducted.

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The Use of Hyperbaric Oxygen in Urology

Abstract: Hyperbaric oxygen is a therapeutic alternative which complements the surgical and medical options for select patients.

Cited by 98 publications

References 57 publications

Is there a role for hyberbaric oxygen as primary treatment for grade IV radiation-induced haemorrhagic cystitis? a prospective pilot-feasibility study and review of literature

Is there a role for hyberbaric oxygen as primary treatment for grade IV radiation-induced haemorrhagic cystitis? a prospective pilot-feasibility study and review of literature

Hyperbaric oxygen therapy for interstitial cystitis resistant to conventional treatments

Management of radiation cystitis

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