Hyperbaric Oxygen Therapy for Soft Tissue Radiation Necrosis of the Bladder​

​Subject: The patient was a 73-year-old man with radiation-induced damage to his urinary bladder as a result of previous treatment for adenocarcinoma of the prostate. The patient complained of frequent urination with recurrent bouts of hematuria that required hospitalization and fulguration of his bladder. His sleep was disturbed by the frequent need to urinate and he complained of chronic loose stools.

Diagnosis: Kialing Perez, MD, medical director of PeaceHealth's Hyperbaric Center, identified the patient as an appropriate candidate for adjunctive hyperbaric oxygen therapy for radiation cystitis and possible radiation enteritis. The patient received a course of 40 outpatient hyperbaric treatments. Each treatment comprised two hours of pressurization to 2.4 atmospheres absolute pressure with 90 minutes of 100 percent oxygen breathing at this pressure.

Treatment: The patient reported marked improvement of symptoms as his treatment progressed. His urine was no longer hematuric and urination frequency had decreased. The chronic diarrhea/loose stools he had experienced also had decreasedBy treatment 18, the patient reported that he was able to sleep through the night for the first time without waking up to use the bathroom. Improvement continued steadily until treatment 34, when symptoms began to return. Following consultation with the patient's urologist, Dr. Perez ordered 20 more sessions. Those sessions resulted in ongoing improvement of the patient's symptoms.

Outcome: At the conclusion of the 60-session treatment course, the patient reported significant improvement in his lifestyle. His symptoms had fully resolved. He no longer experienced nocturia​, incontinence or hematuria. The only side effect he experienced from treatment was a slight deterioration of the visual acuity in both eyes. This common side effect is transient and typically resolves within six to eight weeks after hyperbaric treatment ends.

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