Interstitial Cystitis

Hyperbaric oxygen therapy for painful bladder syndrome/interstitial cystitis resistant to conventional treatments: long-term results of a case series in Japan

Tomoaki Tanaka, Yujiro Nitta, Kazuya Morimoto, Noriaki Nishikawa, Chikako Nishihara, 

Satoshi Tamada, Hidenori Kawashima & Tatsuya Nakatani 

BMC Urology volume 11, Article number: 11 (2011) 

 

Abstract

Background

There is no confirmed strategy for treating painful bladder syndrome/interstitial cystitis (PBS/IC) with unclear etiology. Therefore, a pilot study was carried out to evaluate the efficacy and safety of hyperbaric oxygen (HBO) therapy in treatment-resistant PBS/IC patients.

Methods

HBO treatment (2.0 ATA for 60 minutes/day × 5 days/week for 2 or 4 weeks) was performed on 11 patients with severe symptoms that had not been improved by previous therapy regimens between December 2004 and July 2009.

Results

Seven of the 11 patients demonstrated persistent improvement in symptoms during the 12 months after HBO treatment. These responders demonstrated a decrease in the pelvic pain scale and urgency scale from 7.7 ± 1.0 and, 6.6 ± 0.9 to 3.4 ± 2.5 and 4.3 ± 2.4 after 12 months, respectively (p < 0.05). The total score of the interstitial cystitis symptom index and 24-hour urinary frequency demonstrated a significant sustained decrease from the baseline. Two responders, who received an additional course of HBO 12 and 13 months after initial treatment, respectively, did not suffer impairment for more than two years. There was one case of transient eustachian tube dysfunction and three cases of reversible exudative otitis media as a consequence of HBO treatment.

Conclusions

HBO is a potent treatment for PBS/IC patients resistant to conventional therapy. It was well tolerated and provided maintained amelioration of pain, urgency and urinary frequency for at least 12 months.

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Hyperbaric Oxygen Therapy in Interstitial Cystitis/Painful Bladder Syndrome

S. G. Parker1#, I. Miakhil2 , S. S. Kommu1 1 Urology Department, The Princess Royal University Hospital, South London Healthcare NHS Foundation Trust, Bromley, UK 2 Department of Urology, Peterborough City Hospital, Edith Cavell Campus, Peterborough, UK

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ABSTRACT

Introduction

Hyperbaric oxygen therapy (HBO) is emerging as an alternative technique for treating refractory interstitial cystitis (IC). The theory is that the increased dissolved oxygen in the blood raises the levels of oxygen in the tissues and improves tissue healing. Other urological disorders such as radiation cystitis, Fournier’s gangrene and cyclophosphamide cystitis have also shown a good response to HBO therapy.

Method

A literature search with the terms “interstitial cystitis”, “painful bladder syndrome” and “hyperbaric oxygen therapy” found four papers that have trialed HBO therapy in IC patients; three case series and one randomized control trial.

Results

A total of 31 patients have been treated with HBO therapy. All four studies show a symptomatic improvement in pain, urgency, bladder capacity and O’Leary-Sant interstitial cystitis index. Urinary frequency only improved in three out of four of the trials. The percentage of patients considered as responders to treatment varied at 25%, 66.7%, 82% and 100%.

Conclusion

Preliminary trials of HBO therapy seem to have a good patient response with effective symptomatic relief. The patient response rates varied greatly between the trials. This is due to each trial’s different definition of a “patient responder”. Further work in urology departments at HBO centers is required to further assess the benefits of HBO treatment in IC.