Hyperbaric oxygen therapy for radiation-induced haemorrhagic cystitis.

OBJECTIVE To assess the efficacy of hyperbaric oxygen (HBO) for treating haemorrhagic cystitis. PATIENTS AND METHODS From February 1997 to April 2004, seven patients with radiation-induced haemorrhagic cystitis were treated with HBO; they received a mean (range) of 30 (18-57) HBO treatments and the follow-up was 24 (3-53) months. RESULTS The haematuria resolved completely in all seven patients shortly after treatment; one had an improvement but died from complications relating to cancer shortly after completing treatment, and two had recurrence of gross haematuria. They were re-treated with HBO until the haematuria resolved. CONCLUSIONS Radiation-induced haemorrhagic cystitis can be treated successfully with HBO primarily or after failure of standard regimens. This method was well tolerated even in patients debilitated by advanced cancer and blood loss. Long-term remission is possible in most patients, and re-treatment effectively manages recurrent bleeding.