title: Cryosurgery, an alternative treatment option for organ-confined prostate cancer: current beliefs and practice patterns of urologists.
abstract: OBJECTIVE
  We aim to evaluate the current beliefs and practice patterns of urologists in regard to use of cryosurgery for management of PCa.
  
  
  METHODS
  An anonymous 13-point survey was designed and sent out to members of the Society of Urologic Oncology (SUO), Endourological Society (ES) and American College of Cryosurgery (ACC). Descriptive statistics and univariate analyses were used to determine variables associated with the use of cryosurgery.
  
  
  RESULTS
  Of the 206 responses received [81 (39.2 %) SUO; 106 (51.5 %) ES; 19 (9.2 %) ACC], 83 (40.3 %) performed cryosurgery. The majority of respondents who utilize cryosurgery do so in unilateral (80.3 %) and bilateral (77.6 %) intermediate-risk PCa. Also, users of this technology indicated significant use in primary treatment (>72 %), salvage treatment (>83 %), in patients who prefer cryosurgery (89.9 %) have a life expectancy ≥10 years (65.8 %) and poor erections (74.7 %). The main reason for not utilizing cryosurgery was the lack of technical expertise (56.7 %). A urologist in a non-academic practice setting was 3.2 times more likely to perform cryosurgery compared to a urologist in an academic setting, p = 0.0001.
  
  
  CONCLUSIONS
  Cryosurgery is increasingly being accepted among urologists. However, the need for large-scale studies as well as randomized clinical trials to further delineate the benefits of cryosurgery and convince the non-users and institutions cannot be overemphasized.
authors.affiliation: Department of Urology, Winthrop University Hospital, 1300 Franklin Ave, Mineola, Garden City, NY, 11530, USA. speeditomike@gmail.com.
authors.forename: Michael
authors.identifier: http://orcid.org/0000-0001-5727-5775
authors.initials: M
authors.lastname: Kongnyuy
authors.affiliation: Department of Urology, Winthrop University Hospital, 1300 Franklin Ave, Mineola, Garden City, NY, 11530, USA.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Halpern
authors.affiliation: Department of Urology, Winthrop University Hospital, 1300 Franklin Ave, Mineola, Garden City, NY, 11530, USA.
authors.forename: Kaitlin E
authors.initials: KE
authors.lastname: Kosinski
authors.affiliation: Department of Urology, Winthrop University Hospital, 1300 Franklin Ave, Mineola, Garden City, NY, 11530, USA.
authors.forename: Aaron E
authors.initials: AE
authors.lastname: Katz
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data; D002983:Clinical Competence; D003452:Cryosurgery / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D057240:Patient Preference; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011471:Prostatic Neoplasms / Q000601:surgery*; D011795:Surveys and Questionnaires; D014572:Urology / Q000706:statistics & numerical data*
keywords: Beliefs; Cryosurgery; Patterns; Prostate cancer; Survey