Department of Urology, Unidade Local de Saúde de Matosinhos, Hospital Pedro Hispano, Matosinhos, Portugal.
Department of Urology, Unidade Local de Saúde de Matosinhos, Hospital Pedro Hispano, Matosinhos, Portugal.
Actas Urol Esp (Engl Ed). 2020 Oct;44(8):561-567. doi: 10.1016/j.acuro.2020.03.010. Epub 2020 Jul 28.
Bladder complications may be seen in up to 12% of patients treated with pelvic irradiation. Hyperbaric oxygen therapy (HBOT) is an option for the management of radiation-induced hemorrhagic cystitis (RIHC). The aim of this study was to evaluate the efficacy of HBOT in radiation cystitis and to identify the predictive factors for a successful outcome.
We retrospectively reviewed 105 patients diagnosed with RIHC which were treated with HBOT between 2007 and 2016 in our institution. Patients received 100% oxygen in a multiplace hyperbaric chamber at 2.4atm for 80minutes. All patients fulfilled a questionnaire documenting symptom severity pre-HBOT and at the end of the follow-up period.
After a median of 40 HBOT sessions, there was success rate of 92,4% in the control of hematuria. During our follow-up period (median of 63 months) 24,7% patients presented with recurrence of hematuria. The mean score of the questionnaire-assessed variables: dysuria, urinary frequency and hematuria, was significantly lower after the follow-up period (P<.05). Our data shows that the sooner HBOT is delivered after the first episode of hematuria, better response rates are achieved and lower recurrences concerning hematuria were registered (P<.05). No serious complications were observed.
Our results support the safety and long-term benefits of HBOT on RIHC and other distressful bladder symptoms, which represents an expected improvement of quality of life in our patients.
膀胱并发症可能发生在高达 12%接受骨盆放疗的患者中。高压氧治疗(HBOT)是治疗放射性出血性膀胱炎(RIHC)的一种选择。本研究的目的是评估 HBOT 在放射性膀胱炎治疗中的疗效,并确定获得良好疗效的预测因素。
我们回顾性分析了 2007 年至 2016 年期间在我院接受 HBOT 治疗的 105 例 RIHC 患者。患者在 2.4atm 的多人高压舱中接受 100%氧气治疗 80 分钟。所有患者均填写了一份问卷,记录 HBOT 前和随访结束时的症状严重程度。
在中位数为 40 次 HBOT 治疗后,血尿控制的成功率为 92.4%。在我们的随访期间(中位数为 63 个月),24.7%的患者出现血尿复发。随访后,问卷评估变量的平均评分:尿痛、尿频和血尿均显著降低(P<.05)。我们的数据表明,HBOT 在首次血尿发作后越早进行,获得的反应率越高,血尿复发率越低(P<.05)。未观察到严重并发症。
我们的结果支持 HBOT 治疗 RIHC 和其他痛苦性膀胱症状的安全性和长期益处,这代表了我们患者生活质量的预期改善。