An experience of hyperbaric oxygen and transurethral coagulation combination therapy for abnormal vessels and intractable macrohematuria due to pelvic arteriovenous malformations

A 78-year-old man was admitted to our hospital with a chief complaint of gross hematuria. The patient was diagnosed with pelvic arteriovenous malformations and repeated arterial embolization. A cystoscopy demonstrated that bladder trigone was covered by many clots. At the same time, bleeding mucosa at the right side of the bladder dome was confirmed. We administered hyperbaric oxygen therapy 7 days after admission. Macrohematuria recovered gradually and we then performed transurethral coagulation at the dome with failed mucosa 14 days after admission. Macrohematuria recovered completely and there was no recurrence during hospitalization. Thirty days after admission, we performed cystoscopy and found clear mucosa in the trigone. The patient was discharged 32 days after admission.