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Prog Urol. 2017 Jan;27(1):17-25. doi: 10.1016/j.purol.2016.11.002. Epub 2016 Dec 16.

[Prognostic factors of hyperbaric oxygen therapy in hemorrhagic radiation cystitis].

[Article in French]

Author information

1
Département d'urologie, CHU de Toulouse-Rangueil, 31059 Toulouse, France.
2
Centre de médecine hyperbare, CHU de Toulouse-Purpan, 31059 Toulouse cedex 9, France.
3
Service de radiochirurgie stéréotaxique, CHU, 31059 Toulouse cedex 9, France.
4
Département d'urologie, CHU de Toulouse-Rangueil, 31059 Toulouse, France. Electronic address: huyghe.e@chu-toulouse.fr.

Abstract

OBJECTIVE:

To emphasize prognostic factors of hyperbaric oxygen therapy (HBOT) on hematuria at 3 and 12 months in the context of a radiation cystitis.

MATERIAL AND METHODS:

A cohort of 134 patients was treated from 2008 to 2013 in the hyperbaric medicine center of Toulouse University Hospital, France for radiation cystitis. Hematuria was ranked using the SOMA score. HBOT has been applied according to a standardized protocol of 20 renewable sessions, with pure oxygen to 2.5 ATA. The median number of sessions at 12 months was 50.

RESULTS:

HBOT had an efficacy of 83% at 3 months and 81% at 12 months. Twenty percent of patients had minor side effects. Compared to the pre-HBOT period, the number of hospitalizations decreased by 75% following treatment. The efficacy at 3 months was predictive of efficacy at 12 months (P<0.0001). There was an inverse correlation between the initial grade and efficacy at 3 months (P=0.026) and 12 months (P=0.001). A high WHO status diminished HBOT efficacy at 3 and 12 months (P=0.0014 and P<0.0001, respectively). An anticoagulant intake decreased the HBOT response at 12 months (P=0.002). Other parameters had no effects on efficacy.

CONCLUSION:

The efficacy at 3 months seems to be predictive of efficacy at 12 months. The initial hematuria grade is inversely correlated with efficacy at 3 and 12 months. It appears necessary to achieve at least 32 HBOT sessions. Moreover, a high WHO status and an anticoagulant intake seem to have a negative prognostic value.

LEVEL OF EVIDENCE:

4.

KEYWORDS:

Cystite radique; Hyperbaric oxygen therapy; Hématurie macroscopique; Macroscopic haematuria; Oxygénothérapie hyperbare; Radiation cystitis; SOMA Score; SOMA score

PMID:
27993528
DOI:
10.1016/j.purol.2016.11.002
[Indexed for MEDLINE]

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