M.bennett at 06:55, 9 July 2019

2019-07-09T06:55:51Z

Gordoben: Imported from Wikispaces

2018-12-28T04:09:49Z

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==Intravesical instillation of hyaluronic acid as effective as hyperbaric oxygen for radiation-induced haemorrhagic cystitis ==
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| '''1. Both treatments were equally effective in improving symptoms of haematuria, dysuria and pelvic pain in patients with radiation-induced hemorrhagic cystitis.''' **2. No improvements in frequency was noted in patients of either group at 18 months ''' **post-treatment'''
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'''Citation:''' 
1.Shao Y, Lu GL, Shen ZJ. Comparison of intravesical hyaluronic acid instillation and hyperbaric oxygen in the treatment of radiation-induced hemorrhagic cystitis. BJU Int. 2012 Mar; 109(5):691-4. doi: 10.1111/j.1464-410X.2011.10550.x. Epub 2011 Sep 2.
2.Shao Y, Lu GL, Shen ZJ. Comparison of intravesical hyaluronic acid instillation and hyperbaric oxygen in the treatment of radiation‐induced hemorrhagic cystitis. BJU international. 2012 Mar 1;109(5):691-4.

'''Lead author's name and fax:''' Yuan Shao: shenzhoujun@hotmail.com

'''Three-part Clinical Question:''' For patients with radiation-induced haemorrhagic cystitis (HC), does treatment with intravesicular hyaluronic acid (HA), compared with HBOT, reduce the symptoms of HC?Search Terms: Intravesical hyaluronic acid instillation, hematuria, radiation-induced hemorrhagic cystitis

'''The Study:''' Non-blinded randomised controlled trial without intention-to-treat.The Study Patients: Patients who developed HC after radiotherapy for pelvic malignancies
'''Control group''' (N = 20; 20 analysed): 30 daily sessions at 2.5ATA breathing 100% oxygen for 60 minutes
'''Experimental group''' (N = 16; 16 analysed): Intravesicular instillation of 40mg of HA weekly in the first month and subsequently monthly in the following 2 months.

**The Evidence:'''
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| '''Outcome''' || '''Time to Outcome''' || '''Control group''' || '''HA group''' || '''Relative risk reduction''' || '''Absolute risk reduction''' || '''NNT'''
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| '''Complete response''' || 18 months || 0.45 || 0.5 || 11% || 0.05 || 20
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|^ |||||| 95% CI: || -62% to 84% || -0.28 to 0.38 || NNT ''' 3 to INF; NNH ''' 4 to INF
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| '''No clots, but macroscopic haematuria persisting''' || 18 months || 0.30 || 0.25 || 17% || 0.05 || 20
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|^ |||||| 95% CI: || -81% to 100% || -0.24 to 0.34 || NNT ''' 3 to INF; NNH ''' 4 to INF
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{|
| '''Outcome''' |||| '''HBOT Group''' |||| '''HA Group''' || '''Difference''' || '''95% CI'''
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|^ || '''Mean''' || '''SD''' || '''Mean''' || '''SD''' ||^ ||^
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| '''Visual analogue scale (pelvic pain) at 18 months''' **(0 to 10)''' || 1.35 || 1.69 || 1.25 || 1.53 || 0.10 || -1.01 to 1.21
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| '''Urinary Frequency at 18 months (Voids per day)''' || 10.0 || 1.97 || 10.3 || 1.5 || -0.30 || -1.51 to 0.91
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**Comments:'''
1. The exclusion criteria of this study (if any) were not mentioned in the report
2. 25% of patients did not benefit in either group with respect to haematuria symptoms 
3. Decrease in frequency was significant in both groups 6 months after treatment, but was only significant in the HA group 12 months after therapy

'''Appraised by:''' Bryan Hui; Tuesday, 30 April 2013
'''Email:''' bryan.hui@student.unsw.edu.au
'''Kill or Update By:''' December 2019

[[File:sumhorsa.gif|center]]

'''[[Radiation tissue injury | BACK]]'''

Shao - Revision history

M.bennett at 06:55, 9 July 2019

Gordoben: Imported from Wikispaces