Factors Associated With Hematuria Resolution and Hematuria Admissions After Hyperbaric Oxygen Therapy for Chronic Radiation Cystitis.

INTRODUCTION

Hyperbaric oxygen therapy (HBO2) reduces chronic radiation cystitis (RC) bladder bleeding events; however, the time course of hematuria resolution and frequency of post-treatment admission are not well understood.

METHODS

We performed a review of prospectively collected data on patients who received at least 30 HBO2 sessions for RC associated with gross hematuria at our center. The primary outcome was time to short-term point of care urine hematuria resolution. The secondary outcomes included rates of readmission for hematuria management pre HBO2 and post HBO2 completion and patient factors associated with these outcomes. Chi-square analyses evaluated associations between clinical characteristics and short-term and long-term outcomes.

RESULTS

A total of 43 patients met inclusion criteria, 60% (26/43), 79% (34/42), and 100% (12/12) of patients presenting for HBO2 with macroscopic hematuria demonstrated resolution of gross hematuria by 20, 40, and 60 treatments, respectively. Hematuria admissions decreased from the year before to after HBO2 (1.2 admissions pre vs 0.3 post, 95% CI 0.4-1.2, P < .001). Twelve patients (27%) were readmitted after HBO2 (mean follow-up 2.7 years). A greater proportion of those readmitted had Radiation Therapy Oncology Group scores ≥ 3 (42%, [5/12] vs 7% [1/14], P < .05) and more severe baseline patient-reported hematuria (36% [9/25] vs 7% [1/15], P < .05).

CONCLUSIONS

HBO2 was associated with short-term hematuria resolution and fewer long-term hospitalizations for RC hematuria. More severe baseline RC indicators predicted post-HBO2 hematuria hospitalizations. These findings suggest that some patients may benefit from tailored treatment courses and that early HBO2 initiation may lead to better long-term outcomes.