Cryosurgical ablation for prostate cancer: preliminary results of a new advanced technique.
BACKGROUND
Cryosurgery is a minimally invasive treatment option for prostate cancer.


OBJECTIVE
To report on the first series of cryosurgical ablation for prostate cancer performed in Israel.


METHODS
Cryosurgical ablation of the prostate was undertaken in 12 patients aged 53-72 diagnosed with adenocarcinoma of the prostate. The procedures were performed percutaneously and were monitored by real-time trans-rectal ultrasound. The CRYOHIT machine applying Argon gas was used with standard or ultra-thin cryoprobes. The average follow-up was 12.8 months postsurgery (range 1-24 months).


RESULTS
No rectal or urethral injuries occurred and all patients were discharged from hospital within 24-48 hours. The duration of suprapubic drainage was 14 days in 10 patients and prolonged in 2. Early complications included penoscrotal edema in four patients, perineal hematoma in three, hemorrhoids in two and epidydimitis in one. Long-term complications included extensive prostatic sloughing in one patient and a perineal fistula in another, both of whom required prolonged suprapubic drainage. Minimal stress incontinence was noted in two patients for the first 8 weeks after surgery. None of the patients has yet regained spontaneous potency. A prostate-specific antigen nadir of less than 0.5 ng/ml was achieved in eight patients and an undetectable PSA level below 0.1 ng/ml in five patients.


CONCLUSIONS
Cryoablation for prostate cancer is safe and feasible, and the preliminary results are encouraging. Further study is needed to elucidate the efficacy of the procedure.
Leibovici
D
D
Department of Urology, Assaf Harofeh Medical Center, Zerifin, Israel.
Zisman
A
A
Siegel
Y I
YI
Lindner
A
A
D000230:Adenocarcinoma / Q000097:blood / Q000000981:diagnostic imaging / Q000601:surgery*; D000368:Aged; D003452:Cryosurgery / Q000009:adverse effects / Q000379:methods*; D004487:Edema / Q000209:etiology; D004823:Epididymitis / Q000209:etiology; D007172:Erectile Dysfunction / Q000209:etiology; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006406:Hematoma / Q000209:etiology; D006484:Hemorrhoids / Q000209:etiology; D006801:Humans; D007557:Israel; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods; D011183:Postoperative Complications; D011467:Prostate / Q000000981:diagnostic imaging / Q000601:surgery; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000601:surgery*; D012002:Rectal Diseases / Q000209:etiology; D012003:Rectal Fistula / Q000209:etiology; D014463:Ultrasonography; D014550:Urinary Incontinence, Stress / Q000209:etiology
D017430:Prostate-Specific Antigen