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Utility of Hyperbaric Oxygen Therapy in Genitourinary Reconstruction

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Textbook of Male Genitourethral Reconstruction

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Abstract

Background Hyperbaric Oxygen Therapy (HBOT) has numerous applications set forth by the Undersea and Hyperbaric Medical Society. Favorable properties of HBOT include increased oxygen delivery to compromised tissue, and promotion of angiogenesis. HBOT has been used in reconstructive surgery since the 1960’s primarily in the setting of threatened flaps and grafts with a good track record of improved wound healing.

Applications in Urology Uses of HBOT in urology have been more limited, at least in the published literature, and include repair of hypospadias, urethral stricture, urinary fistula, radiation-induced hemorrhagic cystitis (RHC), and Fournier’s gangrene. Evidence for HBOT in hypospadias repair best supports use in reoperation, particularly in third or fourth repeat procedures. In urethral stricture disease there’s limited evidence for hastened recovery of erectile function with HBOT following repair. HBOT use in both Fournier’s disease and fistula repair has a theoretical benefit but no compelling clinical evidence to favor its routine use. In patients with HRC, 84% treated with HBOT experienced at least partial resolution of symptoms. HBOT in this setting has a durable response with only 14% of patients reporting recurrence during at least 1 year of follow up.

Conclusions There are no randomized control trials evaluating the use of HBOT in any urologic condition. Available data from retrospective series and borrowed experience from use in other reconstructive surgeries supports a limited role for HBOT within urology. Most supported use is in patients with prior radiation exposure, threatened flaps or grafts, and early initiation of HBOT therapy when it’s indicated.

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Author information

Authors and Affiliations

  1. Department of Surgery, Division of Urology, University of Utah School of Medicine, Salt Lake City, UT, USA

    Austen D. Slade & Jeremy B. Myers

  2. Department of Urology, University of Lisbon, School of Medicine, Santa Maria University Hospital, Lisbon, Portugal

    Francisco E. Martins

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  1. Austen D. Slade
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  2. Francisco E. Martins
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Editors and Affiliations

  1. School of Medicine, University of Lisbon, Lisbon, Portugal

    Francisco E. Martins

  2. Kulkarni Reconstructive Urology Center, Pune, India

    Sanjay B. Kulkarni

  3. Department of Urology, Mayo Clinic, Rochester, MN, USA

    Tobias S. Köhler

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Slade, A.D., Martins, F.E., Myers, J.B. (2020). Utility of Hyperbaric Oxygen Therapy in Genitourinary Reconstruction. In: Martins, F.E., Kulkarni, S.B., Köhler, T.S. (eds) Textbook of Male Genitourethral Reconstruction. Springer, Cham. https://doi.org/10.1007/978-3-030-21447-0_36

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  • DOI: https://doi.org/10.1007/978-3-030-21447-0_36

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