Sexual health following hyperbaric oxygen treatment in pelvic cancer survivors with radiation injuries: a longitudinal observational study.

BACKGROUND

Hyperbaric oxygen therapy (HBOT) is an established treatment for pelvic late radiation tissue injuries (LRTIs) in cancer survivors, yet its impact on sexual health outcomes has previously not been examined.

AIM: To investigate longitudinal changes in sexual health following HBOT in pelvic cancer survivors with LRTIs and to examine whether baseline severity and changes in pelvic LRTI symptoms predict sexual health outcomes, including gender differences.

METHODS

This one-group longitudinal observational study included eight assessment points. A total of 137 cancer survivors with pelvic LRTIs underwent 27-30 HBOT in monoplace chambers, breathing 100% oxygen for 90 min at 2.4 atmospheres absolute. Data were analyzed using latent growth curve modeling.

OUTCOMES: Sexual health was assessed using the EORTC Quality of Life Sexual Health Questionnaire, while pelvic LRTIs (urinary and bowel) were measured using the Expanded Prostate Cancer Index Composite.

RESULTS

Sexual health scores did not change significantly over 58 weeks (total change = -0.49, P = .742), despite significant improvements in urinary (total change = 8.98 points; P < .001) and bowel symptoms (total change = 8.25 points; P < .001). Greater early improvement in urinary symptoms predicted higher sexual satisfaction (95% CI = 0.02-0.19; P = .015), with stronger associations observed among men (bmale*change = 3.30, P = .032, CI = 0.38, 6.32).

CLINICAL IMPLICATIONS: Although HBOT improves pelvic LRTIs, persistent sexual health challenges highlight the need for comprehensive, multidisciplinary survivorship care.

STRENGTHS AND LIMITATIONS: Strengths include a relatively large, gender-balanced sample, longitudinal design, validated measures, and a standardized treatment protocol. The absence of a control group limits causal inference.

CONCLUSION

Despite improvement of urinary and bowel symptoms, HBOT does not seem to restore sexual health. Further research is needed to confirm these findings and address other sexual health interventions. ClincalTrials.gov registration number NCT03570229.