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Negative effects on the bladderwall can occur after therapeutic radiation of a pelvic organ, such as bladder, prostate or cervix. It can cause acute (transient) bladder complaints, but symptoms can also emerge years after treatment with the development of chronic radiation cystitis. This causes bothersome symptoms, such as frequency, urgency, urinary incontinence, chronic pelvic pain and/or macroscopic hematuria. The latter can lead to multiple emergency hospital admissions in some patients. In refractory hemorrhagic cystitis, a therapeutic flowchart can be used to guide optimal additional treatment. Especially in mild to moderate macrohematuria hyperbaric oxygen therapy (HBOT) can be considered. It has recently become more mainstream, it is safe and seems to be effective. [ABSTRACT FROM AUTHOR]