Clinical effect of transurethral thulium laser coagulation combined with hyperbaric oxygen therapy in the treatment of radiation-induced hemorrhagic cysti
10.3760/cma.j.cn311847-20211128-00320
- VernacularTitle:经尿道膀胱铥激光止血联合高压氧治疗放射性出血性膀胱炎的疗效观察
- Author:
Tianyuan XU
1
;
Yang YAN
;
Jingcun ZHENG
;
Jiang GENG
;
Ming LUO
Author Information
1. 上海同济大学附属第十人民医院泌尿外科，上海 200072
- Publication Type:Journal Article
- Keywords:
Radiation-induced cystitis;
Hematuria;
Hyperbaric oxygen therapy;
Thulium laser
- From:
Chinese journal of nautical medicine and hyperbaric medicine
2022;29(2):216-220
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical effects of transurethral thulium laser coagulation combined with hyperbaric oxygen（HBO）therapy in the treatment of radiation-induced hemorrhagic cystitis（RIHC）.Methods:From January 2014 to June 2020，10 patients with gross hematuria were diagnosed as RIHC in the Department of Urology of the Tenth People’s Hospital of Tongji University. Their clinical data were retrospectively analyzed. There were 7 males and 3 females，with an average age of 69.4 yrs（range 47-81）. Their mean baseline hemoglobin level was 91.4 g/L（range 58-123）and mean overactive bladder syndrome score（OABSS）was 7.8（range 3-13）. All patients received transurethral thulium laser coagulation combined with HBO therapy and were followed up at 1，3，6，and 12 months after treatment. The follow-up examination included gross hematuria evaluation，OABSS，detection of hemoglobin，and the count of microscopic red blood cells. Cystoscopies were also performed at month 6 and 12 to assess the therapeutic effects.Results:All patients completed the treatment. No grade 3-4 perioperative complications occurred，and no severe side effects such as severe barotrauma，oxygen poisoning，and decompression sickness were found during HBO therapy. After treatment，the hemoglobin levels at month 1，3，6 and 12 were significantly increased，and the results of OABSS were significantly decreased at all time points. The increases of hemoglobin at month 1 and 3 as well as the decrease of OABSS at month 1 showed statistically significant difference from their former performance，respectively（ P<0.05）. In the follow-up at month 12，the cystoscopies showed that 6 patients were cured，3 patients got their symptoms relieved，while 1 patient still suffered from gross hematuria repeatedly. The total effective rate of the combined treatment was 90%. Conclusion:Transurethral thulium laser coagulation combined with HBO has a high effective rate. It can significantly improve gross hematuria and relieve urinary tract symptoms. Thus it’s an effective treatment method for RIHC.
