[abstract] BRACHYTHERAPY-INDUCED PENILE NECROSIS TREATED WITH HYPERBARIC OXYGEN

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[abstract] BRACHYTHERAPY-INDUCED PENILE NECROSIS TREATED WITH HYPERBARIC OXYGEN

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Title: [abstract] BRACHYTHERAPY-INDUCED PENILE NECROSIS TREATED WITH HYPERBARIC OXYGEN
Author: Evans, AW; Levin, W; Crook, J
Abstract: Background: A case is described where (HBOT) was successfully employed in the management of a urological soft tissue radiation injury. Materials and Methods: A 49 year-old male developed a deeply infiltrating 2.5 x 3 cm T3 squamous cell cancer on the ventral surface of the glans penis. In order to avoid penile amputation, he elected to have brachytherapy as the primary management, combined with a groin node dissection. A painful 2 cm ulceration subsequently remained at the site of the previous tumor. After 14 months of conservative management, a six week course of hyperbaric oxygen therapy was employed for microvascular rehabilitation. Results: Symptomatic relief was dramatic. After only 9 treatments, the ulcer decreased in size and narcotic analgesia was discontinued. Unfortunately, a seven-week interruption due to SARS resulted in the reoccurrence of pain without clinical change in the ulcer. HBOT was re-commenced and resulted in further healing and symptomatic improvement, although healing remained incomplete at the conclusion of the 40-treatment series. Within 3-4 months, pain recurred and the necrotic ulcer extended and became cavitating. Partial penectomy and/or reconstructive surgery were considered. A further four-week course of HBOT was commenced and resulted in essentially complete healing before the surgical date was reached. Skin sensation in the area of ulceration returned. The patient is currently pain free and surgery has been cancelled, although future reduction of a hypospadius may be necessary. Conclusions: The post-radiotherapy morbidity suffered by this patient was dramatically altered by repeated courses of hyperbaric oxygen therapy to achieve healing, resulting in the improvement in quality of life and avoidance of salvage surgery. The use of HBOT should be considered early in the evolution of radiotherapy late effects.
Description: Undersea and Hyperbaric Medical Society, Inc. (http://www.uhms.org )
URI: http://archive.rubicon-foundation.org/1498
Date: 2004

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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