Usefulness of hyperbaric oxygen therapy in urological conditions

Hyperbaric oxygen therapy (HBOT) is a systemically acting treatment modality. It is used for various conditions on a broad range of pathologies implicating many medical specialties and has been evolving for more than 8 decades when it was first introduced into clinical practice. HBOT use for Urological diseases has been extensive ranging from use in aggressive potentially lethal infections (Fournier’s gangrene [FG] and necrotizing fasciitis [NF]) to functional morbidity caused by interstitial cystitis and erectile dysfunction. Undoubtedly, the highlight of its usefulness for the Urologist is the management of post-radiation tissue injury relating to that specialty area. Post-radiation hemorrhagic cystitis particularly, is a condition where HBOT has been extensively used with very good results. Research on that topic has been accumulated, including our own published experience, and HBOT is strongly recommended (Type 1 recommendation, Level B evidence) by the European Committee of Hyperbaric Medicine (ECHM) for hemorrhagic radiation cystitis. As Hyperbaric Oxygen benefit may be relevant to other hypoxic/hypocellular/infectious conditions concerning the Urologist, this paper will discuss its practice and mechanisms of action leading to its use in various urological conditions.