Management of postoperative radiation injury of the urinary bladder by hyperbaric oxygen (HBO)

Abstract

Aim: In many case reports the success of treatment of late complications of radiotherapy with hyperbaric oxygenation (HBO) has been shown. This synopsis attempts to review HBO in the treatment of chronic radiation injury of the bladder.

Patients and methods: Three female patients who had developed urge-incontinence after a Wertheim operation and combined brachy-teletherapy with cobalt-60 and afterloading and did not respond to various drug therapies, were treated with HBO to a maximum of 40 applications.

Results: In all patients HBO altered and inverted the dynamic process underlying chronic bladder changes after irradiation. Rationales for the HBO are the reduction of tissue hypoxia and the induction of neoangiogenesis.

Conclusions: There are no prospective trials up to date showing the benefit of HBO to urinary disorders caused by radiation cystitis. The positive results of our retrospective study should encourage clinicians to initiate prospective studies with the use of HBO in the treatment of radiation cystitis.