OutcomesAnalysis of Urinary Function Using Validated Instruments and Uroflowmetry After Primary and Salvage Prostate Cryoablation
Section snippets
Patient Selection, Assessment, and Follow-Up
Between January 2002 and October 2008, a total of 74 patients with complete records regarding urinary function were included in this study. The mean follow-up period was 42.5 ± 20.3 months. All patients with biopsy-proven PCa underwent cryoablation as primary or salvage therapy. All primary patients were diagnosed with T1c or T2 disease according to the American Joint Committee on Cancer classification (2002 staging system). Urinary function was evaluated using the International Prostate
Baseline Characteristics
The baseline characteristics of this cohort are summarized in Table 1. Of the 74 patients, only 2 (2.7%) presented with prolonged mild stress incontinence after cryoablation. No patients presented with persistent urinary retention or urethral fistula. A total of 11 primary patients were subjected to temporary hormonal therapy (within 3 months of cryotherapy) and 11 salvage patients were exposed to temporary hormonal therapy at the time of radiation therapy, which was discontinued before
Comment
Cryoablation is recognized as an established minimally invasive procedure for the treatment of localized PCa in both the primary and salvage setting.3, 5, 6 Although several reports detailing oncologic outcomes of cryoablation have been published; there are not many series reporting quality of life (QOL) (eg, urinary function and sexual function) after cryoablation using improved third-generation technology. To our knowledge, this is the first study evaluating urinary function after prostate
Conclusions
Third-generation cryo-technology is a minimally invasive modality for the treatment of localized PCa in a primary and salvage setting. This study is the first report suggesting that cryoablation can preserve and might improve urinary function during the observation period, even if patients had moderate to severe urinary symptoms or a larger prostate volume preoperatively. Additionally, our results revealed that only the salvage setting is a predictive factor for worsening urinary function after
References (22)
- et al.
Salvage cryoablation of the prostate: followup and analysis of predictive factors for outcome
J Urol
(2007) - et al.
Targeted cryoablation of the prostate: 7-year outcomes in the primary treatment of prostate cancer
Urology
(2002) - et al.
Short-term cancer control after primary cryosurgical ablation for clinically localized prostate cancer using third-generation cryotechnology
Urology
(2007) - et al.
Satisfaction and regret after open retropubic or robot-assisted laparoscopic radical prostatectomy
Eur Urol
(2008) - et al.
Treatment of organ confined prostate cancer with third generation cryosurgery: preliminary multicenter experience
J Urol
(2003) - et al.
Thermal protection of urethra during cryosurgery of prostate
Cryobiology
(1994) - et al.
Whole gland primary prostate cryoablation: initial results from the cryo on-line data registry
J Urol
(2008) - et al.
Eight years experience of local prostate cancer treatment with permanent I 125 seed brachytherapy—morbidity and outcome results
Radiother Oncol
(2009) - et al.
Side effects of permanent I 125 prostate seed implants in 667 patients treated in Leeds
Radiother Oncol
(2007) - et al.
Cryosurgical treatment of the prostate
Invest Urol
(1966)
Single center experience with third-generation cryosurgery for management of organ-confined prostate cancer: critical evaluation of short-term outcomes, complications, and patient quality of life
J Endourol
Cited by (11)
Salvage prostate cryoablation for recurrent localized prostate cancer after radiotherapy
2016, Urological ScienceCitation Excerpt :Minimizing LUTSs after cryoablation of the prostate has always been a focus for research. Kimura et al8 reported that SCA is a predictor for poorer postoperational voiding function when compared with primary cryoablation, whereas pre-SCA severity of LUTSs and prostate size were not significantly related. It can be seen from our study that SCA may lead to de novo LUTSs or exacerbate pre-existing LUTSs.
Cryotherapy for Management of Prostate Cancer
2021, Interventional Urology, Second EditionLongitudinal Comparison of Patient-Level Outcomes and Costs Across Prostate Cancer Treatments With Urinary Problems
2019, American Journal of Men's HealthProstate cryotherapy
2017, Management of Prostate Cancer: A Multidisciplinary Approach, Second EditionThe feasibility and safety of repeat cryosurgical ablation of localized prostate cancer
2015, World Journal of Surgical OncologyCryotherapy in prostate cancer
2014, Journal of Clinical Urology