Transurethral bladder cryoablation in the porcine model

Area of Science:

• Urology
• Minimally Invasive Surgery
• Experimental Medicine

Background:

• Transurethral procedures are crucial in urology.
• Focal therapies are gaining traction for bladder conditions.
• Novel ablation techniques require validation in preclinical models.

Purpose of the Study:

• To assess the feasibility of transurethral, focal, full-thickness bladder wall cryoablation.
• To evaluate the safety and efficacy of a novel 38-cm cryoablation probe in a porcine model.
• To investigate the impact of different insufflation methods (saline vs. carbon dioxide) on cryoablation outcomes.

Main Methods:

• Eighteen pigs were divided into three groups, undergoing transurethral bladder wall cryoablation with two freeze-thaw cycles.
• Groups 1 and 2 were treated in a saline environment and sacrificed at 1 and 3 weeks, respectively.
• Group 3 was treated with carbon dioxide insufflation and sacrificed at 1 week, with laparoscopic protection and cystographic/histopathologic evaluation.

Main Results:

• All 18 pigs completed the procedure without evidence of extravasation on cystography.
• Groups 1 and 2 showed no significant complications, while Group 3 had minimal adhesions in 50% of cases.
• Histopathology confirmed full-thickness necrosis in all groups, with cryolesion sizes ranging from 2.3 mm to 8.2 mm.

Conclusions:

• Transurethral, full-thickness bladder wall cryoablation is feasible in a porcine model.
• The novel cryoablation probe effectively induced necrosis while preserving bladder wall integrity.
• This preclinical study supports the potential of focal cryoablation as a therapeutic option in urology.