Reduced symptoms of late radiation tissue injury of the vagina after treatment with hyperbaric oxygen therapy: A retrospective analysis of 19 patients

Abstract

Introduction

Hyperbaric oxygen therapy (HBOT) is a well-established treatment for late radiation tissue injury (LRTI) of the pelvis, such as radiation-cystitis and -proctitis, but not for LRTI of the vagina. This study aims to describe the outcomes of patients with vaginal symptoms after HBOT.

Methods

The records of all patients with LRTI of the vagina, referred for HBOT from a tertiary hospital, between 2010 and 2020 were retrospectively analyzed. Patients with a non-vaginal primary complaint, fistulas, or incomplete HBOT treatment (<20 sessions) were excluded. Outcomes included patient- and physician-reported symptoms (such as dyspareunia, dryness, bleeding, and anatomical changes) and quality-of-life questionnaires. Outcomes were assessed at baseline, after HBOT, 3 months after HBOT, and during yearly follow-up. Responders were defined as patients with ≥1 vaginal symptoms improving after treatment.

Results

19 Patients (median age 42) received an average of 40 sessions of HBOT (80 min of 100 % oxygen at 2.5 ATA). 15/19 patients (79 %) were responders at the end of treatment (median of 3 symptoms improving). The symptoms most responsive to HBOT were ulceration (89 %), dyspareunia (82 %), pain (71 %), and changes in anatomy like stenosis or fibrosis (80 %). Response was maintained during 3 month follow-up in 14/15 patients. No major adverse events of HBOT were reported.

Conclusion

A majority of patients had a lasting improvement of vaginal complaints after HBOT in this study. Based on this study and the generic effects of HBOT in LRTI, HBOT should be considered as a treatment option for patients with ongoing complaints of the vagina due to LRTI.