MANAGEMENT OF POSTOPERATIVE RADIATION-INJURY OF THE URINARY-BLADDER BY HYPERBARIC-OXYGEN (HBO)

Aim: In many case reports the success of treatment of late complicatio ns of radiotherapy with hyperbaric oxygenation (HBO) has been shown. T his synopsis attempts to review HBO in the treatment of chronic radiat ion injury of the bladder. Patients and Methods: Three female patients who had developed urge-incontinence after a Wertheim operation and co mbined 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 haltered and inverted the dynamic process underlying chronic bladder changes after irradiat ion. Rationales for the HBO are the reduction of tissue hypoxia and th e induction of neoangiogenesis. Conclusions: There are no prospective trials up to date showing the benefit of HBO to urinary disorders caus ed by radiation cystitis. The positive results of our retrospective st udy should encourage clinicians to initiate prospective studies with t he use of HBO in the treatment of radiation cystitis.