Preliminary safety and efficacy results with robotic high-intensity focused ultrasound : A single center Indian experience.
BACKGROUND
There are no Indian data of high-intensity focused ultrasound (HIFU). Being an alternative, still experimental modality, reporting short-term safety outcome is paramount.


OBJECTIVE
This study was aimed at to assess the safety and short-term outcome in patients with prostate cancer treated by HIFU.


METHODS
A retrospective study of case records of 30 patients undergoing HIFU between January 2008 to September 2010 was designed and conducted.


METHODS
The procedural safety was analyzed at 3 months. Follow-up consisted of 3 monthly prostate-specific antigen (PSA) levels and transrectal biopsy if indicated. All the patients had a minimum follow-up of 6 months.


RESULTS
A mean prostate volume of 26.9 ± 8.5 cm(3) was treated in a mean time of 115 ± 37.4 min. There was no intraoperative complication. The postoperative pain visual analogue score at day 0 was 2.1 ± 1.9 and at day 1 was 0.4 ± 0.8 on a scale of 1-10. Mean duration of perurethral catheter removal was 3.9 days. The complications after treatment were: LUTS in seven patients, stress incontinence in two, stricture in two, and symptomatic urinary tract infection in five. Average follow-up duration was 10.4 months (range, 6-20 months). Mean time to obtain PSA nadir was 6 ± 3 months with a median PSA nadir value of 0.3 ng/ml. Two patients had positive prostatic biopsy in the localized (high risk) group.


CONCLUSIONS
HIFU was safe in carcinoma prostate patients. The short-term results were efficacious in localized disease. The low complication rates and favorable functional outcome support the planning of further larger studies.
Department of Urology, Muljibhai Patel Urological Hospital, Nadaid, Gujarat, India.
Shashikant
S
Mishra
Rajan
R
Sharma
Chandra Prakash
CP
Garg
V
V
Muthu
Arvind
A
Ganpule
Ravindra B
RB
Sabnis
Mahesh R
MR
Desai