Hyperbaric oxygen reduced gross haematuria and may improve quality of life for patients with radiation cystitis.

1. Hyperbaric oxygenation was associated with improvement in gross haematuria in the short term
2. Some longer-term benefit in haematuria, severity score and quality of life, but all patients received HBOT, so not a randomised outcome.

Citation/s:
Lewis AL, Hardy KR, Huang ET, Bolotin T, Clark JM, Thom SR. Hyperbaric oxygen therapy decreases gross haematuria and improves quality of life in patients with radiation cystitis. Undersea and Hyperbaric Medicine 2005; 32(4)236
Three-part Clinical Question: For patients with radiation cystitis, does hyperbaric oxygen therapy compared to standard approaches to treatment, result in any reduction in haematuria, pain or other related symptoms?
Search Terms: Radiation, cystitis, haematuria

The Study:
Non-blinded randomised cross-over trial with intention-to-treat.
The Study Patients: Symptomatic radiation cystitis including gross haematuria.
Control group (N = 26 ; 19 analysed): Standard therapy (no details) for six weeks, then crossed over to HBOT arm.
Experimental group (N = 26 ; 19 analysed): 100% oxygen at an unspecified pressure daily for six weeks, then crossed to standard arm.

The Evidence:

Outcome

Time to Outcome

Control group rate

Hyperbaric group rate

Relative risk reduction

Absolute risk reduction

Number needed to treat

Resolution of gross haematuria

12 weeks

0.12

0.54

368%

0.42

2

95% Confidence Intervals:

170% to 566%

0.12 to 0.65

2 to 5

 

Non-Event Outcomes

Time to outcome/s

Result

Prostatitis severity survey

12 weeks

Improved after HBOT, but not statistically significant

Quality of Life score

12 weeks

Better, P= 0.007

Long-term follow-up

1.5 yrs

Trends to improvement

Comments:
1. Small study reported in abstract only
2. Cross-over design so that any results longer than six weeks do not represent a randomised comparison
3. Little details of the outcomes measured and the figures above remain speculative to some degree

Appraised by: Mike Bennett, Sydney; Wednesday, 11 July 2007
Email: m.bennett@unsw.edu.au
Kill or Update By: July 2008