Urologic Conditions –
such as Interstitial Cystitis
Click on the publications below to view and close the abstracts
Hyperbaric oxygenation in the treatment of patients with interstitial cystitis: clinical and morphological rationale
Loran OB, Siniakova LA, Seregin AV, Mitrokhin AA, Plesovskiĭ AM, Vinarova NA.
Urologiia. 2011 May-Jun;(3):3-5.
We studied efficacy of hyperbaric oxygenation (HBO) in 8 patients with interstitial cystitis/painful bladder syndrome (IC/PBS). Mean age of the patients was 53 years (35-72 years), mean duration of the disease 7.5 years (6-17 years). Ulcerative IC/PBS was diagnosed in 7 of 8 patients.
The patients received combined treatment: surgical (hydrobouginage of the bladder, electrocoagulation of bladder ulcer) and a HBO course in the postoperative period. The efficacy was assessed by clinical and morphological criteria (estimation of histamine level in urethral smears, proliferative activity of bladder mucosa epithelial cells). A HBO course consisted of 10 sessions (40 min, 2 atm).
The treatment reduced the number of voidings for 24 hours, increased mean effective bladder volume, lowered a total score by L. Parsons scale, histamine content in urethral smears, stimulated proliferative activity of bladder mucosa epithelium. Thus, HBO proved its safety and effectiveness in combined treatment of IC/PBS.
Hyperbaric oxygenation in combined treatment of interstitial cystitis
Pushkar DIu, Zaĭtsev AV, Gavrilenko AP, Matsaev AB, Kasian GR, Kolontarev KB, Farmanov RF
Urologiia. 2010 Jan-Feb; (1):22-4.
A total of 116 female patients with painful bladder syndrome/interstitial cystitis aged 32-78 years (mean age 56 +/- 2.4 years) entered the trial. They were divided into two groups according to treatment.
Group 1 (n = 54) received 10-day combined conservative treatment consisting of antimicrobial drugs (if urinary infection was diagnosed), angioprotectors, mast cell activity stabilizers and bladder instillation with combined solution.
Group 2 included 62 patients whose treatment included complex anti-inflammatory therapy in combination with HBO sessions (7-10 sessions in barochamber OKA-MT, 2.0 +/- 0.2 atm). Subjective (the disease course, pain intensity, 24-h and nocturnal pollakiuria, effective urine volume) and objective (microcirculation in the bladder wall) results were assessed.
Dopplerograms revealed venous stagnation. Patients of group 2 had a persistent improvement of microcirculation in bladder mucosa as shown by better blood flow in the veins and arterioles. In group 1 the above improvement was less pronounced.
Thus, HBO in combined treatment of interstitial cystitis improves treatment results and promotes long-term remission of the disease.
Hyperbaric oxygen therapy for interstitial cystitis resistant to conventional treatments
Tanaka T, Kawashima H, Makino T, Kamikawa S, Kato N, Nakatani T
Int J Urol. 2007 Jun; 14(6):563-5.
We treated two cases of interstitial cystitis (IC) that were resistant to some conventional therapies with hyperbaric oxygen (HBO).
Both patients underwent 20 sessions of 100% oxygen inhalation (2.0 atmosphere absolute for 60 min/day x 5 days/week for 4 weeks) in a hyperbaric chamber. The period of follow up was 12 months for case 1 and 9 months for case 2. After a course of HBO, the bladder mucosal ulcer (Hunner’s ulcer) disappeared, and changes from baseline in pain and urinary frequency was constitutively inhibited.
There were no adverse events during the 20 treatment sessions. One woman (case 1) had mild Eustachian tube dysfunction, resulting in a transient hearing impairment. HBO seems to be an option for treatment of IC resistant to conventional therapies.
Safety and efficacy of hyperbaric oxygen therapy for the treatment of interstitial cystitis: a randomized, sham controlled, double-blind trial
Van Ophoven A, Rossbach G, Pajonk F, Hertle L
J Urol. 2006 Oct; 176(4 Pt 1):1442-6.
PURPOSE: We conducted a double-blind, sham controlled study to evaluate the safety, efficacy and feasibility of hyperbaric oxygenation for interstitial cystitis.
MATERIALS AND METHODS: A total of 21 patients with interstitial cystitis were randomized to 90 minutes treatment in a hyperbaric chamber pressurized with 100% O2 to 2.4 atmosphere absolute for 30 treatments sessions or 1.3 atmosphere absolute, breathing normal air in the control group. Moderate or marked improvement in a global response assessment questionnaire was defined as treatment response (primary outcomes). Secondary measurements included changes of pain and urgency evaluated by visual analog scales, functional bladder capacity and frequency. Changes in the O’Leary-Sant Interstitial Cystitis Index and rating of overall satisfaction with the therapeutic outcome were also reported.
RESULTS: There were 3 of 14 patients on verum and no control patients who were identified as responders (p < 0.52) [corrected] At 12-month followup 3 patients (21.4%) still reported treatment response. Hyperbaric oxygenation resulted in a decrease of baseline urgency intensity from 60.2 +/- 15.0 to 49.9 +/- 35.2 mm at 3 months and decrease of pain intensity from 43.1 +/- 20.5 to 31.2 +/- 19.8 mm, respectively (p < 0.05). The Interstitial Cystitis Symptom Index score sum decreased from 25.7 to 19.9 points in patients on verum. Sham treatment did not result in improvement of the baseline parameters.
CONCLUSIONS: A total of 30 treatment sessions of hyperbaric oxygenation appear to be a safe, effective and feasible therapeutic approach to interstitial cystitis. In the treatment responders application of hyperbaric oxygenation resulted in a sustained decrease of interstitial cystitis symptoms with a discordant profile regarding the peak amelioration of the various interstitial cystitis symptoms compared with a normobaric, normoxic sham treatment.
Hyperbaric oxygen for the treatment of interstitial cystitis: long-term results of a prospective pilot study
Van Ophoven A, Rossbach G, Oberpenning F, Hertle L
Eur Urol. 2004 Jul; 46(1):108-13.
OBJECTIVE: We conducted a prospective pilot study to assess the safety and efficacy of hyperbaric oxygen (HBO) for the treatment of interstitial cystitis (IC).
METHODS: Six patients underwent 30 sessions of 100% oxygen inhalation in a hyperbaric chamber and were followed up over 15 months. The measures of efficacy were changes in pain and urgency (visual analog scales), alteration in the patient’s assessment of overall change in his well-being (Patient Global Assessment Form), and changes in frequency and functional bladder capacity (48-hours voiding log). Evaluation of symptom severity regarding pain and voiding problems was done using the O’Leary-Sant index.
RESULTS: Four patients rated the therapeutic result as either excellent or good and assessed their well-being after HBO treatment as improved. Two patients showed only short-term amelioration of some of their symptoms. At 12 months follow-up the baseline functional bladder capacity increased from 37-161 ml (range) to 160-200 ml in the responder group. The 24-hour voiding frequency decreased from 15-27 to 6-11 voids per day, a pain scale improvement from 20-97 mm at baseline to 3-30 mm at 12 months follow-up and an urgency scale improvement from 53-92 mm to 3-40 mm, respectively was observed at 12 month follow-up. The symptom and pain index score decreased from 23-35 at baseline to 3-17 at 12 months follow-up.
CONCLUSION: HBO appears to be effective to treat IC patients. Treatment was well tolerated and resulted in a sustained decrease of pelvic pain and urgency, improvement of voiding patterns and increase of functional bladder capacity for at least 12 months.
Copyright 2004 Elsevier B.V.