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Cryosurgical ablation of the prostate
1School of Medicine and Biomedical Sciences, State University of New York at Buffalo, 3435 Main St., Buffalo, NY 14214, USA.
Urologic Oncology
|January 14, 2011
Summary
Cryosurgery, a prostate cancer treatment, has resurged due to technological advances. Modern techniques use ultrasound-guided probes for precise freezing, showing promising short-term results for prostate cancer ablation.
Area of Science:
- Urology
- Oncology
- Surgical Technology
Background:
- Cryosurgery for prostatic disease, originating in the 1960s, was nearly abandoned but revived in the 1990s for prostate cancer treatment.
- Renewed interest stems from advancements in intraoperative ultrasound, percutaneous techniques, and cryosurgical equipment.
Purpose of the Study:
- To review the historical background and current status of prostatic cryosurgery for prostate cancer.
- To discuss critical aspects including case selection, technique, and outcomes.
Main Methods:
- Modern cryosurgery involves transperineal percutaneous placement of ultrasound-guided metal probes (typically 5-6, 3mm diameter) into the prostate.
- Probes are cooled to freeze the prostate and potentially extraprostatic extensions, with freezing monitored by ultrasound for controlled ablation.
Main Results:
- Ultrasound guidance allows precise monitoring and control of the freezing boundary during cryoablation.
- Short-term results of cryosurgical ablation for prostate cancer are favorable, encouraging selective application.
Conclusions:
- While long-term outcomes require further evaluation, current data supports cryosurgery as a viable option for select prostate cancer patients.
- Defining optimal patient selection criteria and surgical techniques is crucial for improving cryosurgical treatment efficacy.
