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

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.

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.

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).

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.