Comparison of intravesical hyaluronic acid instillation and hyperbaric oxygen in the treatment of radiation-induced hemorrhagic cystitis

Abstract

Objective: • To compare the efficacy of intravesical hyaluronic acid (HA) instillation and hyperbaric oxygen (HBO) in the treatment of radiation-induced haemorrhagic cystitis (HC).

Patients and methods: • In total 36 patients who underwent radiotherapy for their pelvic malignancies and subsequently suffered from HC were randomly divided into an HA group and an HBO group. • Symptoms of haematuria, frequency of voiding and the visual analogue scale of pelvic pain (range 0-10) were evaluated before and after the treatment with follow-up of 18 months.

Results: • All patients completed this study and no obvious side effects of intravesical HA were recorded. • The improvement rate showed no statistical difference between the two groups at 6, 12 and 18 months after treatment. • Decrease of frequency was significant in both groups 6 months after treatment, but was only significant in the HA group 12 months after therapy. • The improvement in the visual analogue scale remained significant in both groups for 18 months.

Conclusions: • Intravesical instillation of HA was as effective in treating radiation-induced HC as HBO. • It is well tolerated and resulted in a sustained decrease of bladder bleeding, pelvic pain and frequency of voiding for at least 12 months.