RESUMO
PURPOSE OF REVIEW: To critically review and summarize existing literature assessing the effectiveness of hyperbaric oxygen therapy (HBOT) for the treatment of radiation-induced urologic injury. RECENT FINDINGS: Though 5 of the included 13 studies were published in the last 2-3 years, the only randomized controlled study was performed in 2012. Recent studies have confirmed the safety and efficacy of HBOT as well as identified risk factors for success vs. failure of HBOT for hemorrhagic radiation cystitis (HRC). Of the 602 patients that received HBOT for HRC, 84% had a partial or complete resolution. In the 7 studies that utilized RTOG/EORTC, 75% of patients saw an improvement in hematuria of at least one grade (out of possible 5 total). Of the 499 patients with documented follow-up, 14% experienced recurrence, with a median time to recurrence of 10 months (6 to 16.5 months).
Assuntos
Cistite/terapia , Hemorragia/terapia , Oxigenoterapia Hiperbárica , Lesões por Radiação/terapia , Cistite/etiologia , Hemorragia/etiologia , Humanos , Lesões por Radiação/complicações , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Patients undergoing artificial urinary sphincter (AUS) placement often have complex medical and surgical histories, such as radical prostatectomy, endoscopic treatment of urethral strictures, previous AUS placement, and prior open urethral surgery. Urethral strictures at the bladder neck, membranous urethra, or site of a previous AUS erosion are problems that profoundly affect the timing and treatment success of AUS placement. Understanding the complexities and outcomes in this subset of patients is the only way to inform shared decision making about treatment of urinary incontinence.